| NPI | 1306159389 |
|---|---|
| Former Name | ELIZABETH LAUREN HOLLENBECK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 10236) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: PA DS038374) |
| 122300000X Dentist (Licence: NC 10236) | |
| Enumeration Date | 2010-07-20 |
| Last Update Date | 2022-01-31 |