Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 7373 | NC |
NPI | 1023244209 |
---|---|
Provider Name | Dr. William Stewart Laster |
First Address | Raleigh, NC 27615-3354 |
Second Address | Raleigh, NC 27615-3354 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/06/2009 |
Last Update Date | 02/06/2009 |