Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | 8971 | MA |
NPI | 1104042910 |
---|---|
Provider Name | Herlivi Linares |
First Address | Lynn, MA 01903 |
Second Address | Lynn, MA 01901 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2007 |
Last Update Date | 08/07/2007 |