NPI | 1326475518 |
---|---|
Former Name | LAUREN PATRICIA GREGG |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: TX 30860) |
Additional Taxonomies | 122300000X Dentist (Licence: WI 7151-15) |
122300000X Dentist (Licence: IL 019.029526) | |
Enumeration Date | 2013-10-02 |
Last Update Date | 2015-07-30 |