NPI | 1730248808 |
---|---|
Former Name | GAIL A. LUNDQUIST |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: PA DS025064L) |
Enumeration Date | 2006-12-06 |
Last Update Date | 2007-07-08 |