NPI | 1477627032 |
---|---|
Former Name | LANI COOK MCLANE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: MT #2271) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: ID D-4032) |
1223G0001X Dentist, General Practice (Licence: MT 2271) | |
Enumeration Date | 2006-11-17 |
Last Update Date | 2015-11-06 |