Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 19462 | MA |
NPI | 1003971326 |
---|---|
Provider Name | Dr. Lisa A Daft |
First Address | Seekonk, MA 02771-3101 |
Second Address | Barrington, RI 02806-2611 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/12/2006 |
Last Update Date | 08/07/2007 |