Provider Demographics
NPI:1215138672
Name:LASKARIDES, CONSTANTINOS (DMD, DDS, PHARMD)
Entity type:Individual
Prefix:DR
First Name:CONSTANTINOS
Middle Name:
Last Name:LASKARIDES
Suffix:
Gender:M
Credentials:DMD, DDS, PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 KNEELAND ST RM 503
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02111-1527
Mailing Address - Country:US
Mailing Address - Phone:617-636-6648
Mailing Address - Fax:617-636-6809
Practice Address - Street 1:1 KNEELAND ST RM 503
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02111-1527
Practice Address - Country:US
Practice Address - Phone:617-636-6648
Practice Address - Fax:617-636-6809
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-31
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN18552961223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery