Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | DS039603 | PA |
NPI | 1033550751 |
---|---|
Provider Name | Dr. Danielle Ruht Lockwood |
First Address | Lansdale, PA 19446-2637 |
Second Address | Lansdale, PA 19446-2637 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2013 |
Last Update Date | 30/01/2017 |