| NPI | 1376134577 |
|---|---|
| Former Name | LAURIE SUSARCHICK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: IL 019032057) |
| Enumeration Date | 2021-01-30 |
| Last Update Date | 2021-01-30 |