| NPI | 1528216959 |
|---|---|
| Former Name | LORI MICHELLE ANDERSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: FL DN 20505) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: KY 8685) |
| 122300000X Dentist (Licence: OH 30-022877) | |
| Enumeration Date | 2008-08-27 |
| Last Update Date | 2014-03-17 |