Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 18306 | MA |
NPI | 1043314768 |
---|---|
Provider Name | Dr. Lynne Taylor Drizen |
First Address | Essex, MA 01929-1216 |
Second Address | Essex, MA 01929-1216 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/09/2006 |
Last Update Date | 08/07/2007 |