Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | D008990 | AZ |
NPI | 1407260409 |
---|---|
Provider Name | Dr. Lisa Danelle Begay |
First Address | To'hajiilee, NM 87026 |
Second Address | To'hajiilee, NM 87026 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2014 |
Last Update Date | 02/09/2020 |