| NPI | 1528461399 |
|---|---|
| Former Name | LAUREN ANN HANTHORN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CO 00203115) |
| Additional Taxonomies | 122300000X Dentist (Licence: WY 1485) |
| Enumeration Date | 2014-10-07 |
| Last Update Date | 2018-03-17 |