Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 5287 | LA |
NPI | 1114240819 |
---|---|
Provider Name | Dr. Lauren Solange Vedros |
First Address | Kenner, LA 70065-2006 |
Second Address | Kenner, LA 70065-2006 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/03/2010 |
Last Update Date | 09/03/2010 |