| NPI | 1750418588 |
|---|---|
| Former Name | LAURA ANTHONIA RADDATZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MT 1979) |
| Additional Taxonomies | 1223D0001X Dentist, Dental Public Health (Licence: MT 1979) |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2023-12-11 |