Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 03690 | NH |
NPI | 1003003633 |
---|---|
Provider Name | Dr. Lisa Slaughter |
First Address | Somersworth, NH 03878-1522 |
Second Address | Somersworth, NH 03878-1522 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/09/2007 |
Last Update Date | 22/06/2011 |