JOHN LAZZARA, DDS, PA
Dentist at 3 St, Jacksonville, FL

License number
Florida DN 18064
Category
Dentist
Type
Orthodontics and Dentofacial Orthopedics
Owner
Name: DR. JOHN LAZZARA DDS
Title: PRESIDENT
Phone: (904) 806-2238
Address
Address
4184 3Rd St S, Jacksonville, FL 32250
National Provider ID: 1245429604
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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John Lazzara, DDS, PA

Ponte Vedra, FL  -  Jacksonville, FL

Registration:
Jul 19, 2007
Addresses:
333 N Sea Lk Ln, Ponte Vedra, FL 32082
4184 3 St S, Jacksonville, FL 32250
State ID:
P07000082183
Business type:
Domestic for Profit Corporation
President, Treasurer, Secretary:
John Lazzara (President, Treasurer, Secretary)
Agent:
Mitchell W. Legler

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