| NPI | 1962506659 |
|---|---|
| Former Name | LAQUANIS SHENA COLLINS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA DN014862) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: SC 4240) |
| Enumeration Date | 2006-09-12 |
| Last Update Date | 2016-03-14 |