Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 126800000X | Dental Assistant | 119372 | OR |
NPI | 1154768422 |
---|---|
Provider Name | Kati Lee Laplante |
First Address | Milwaukie, OR 97222 |
Second Address | Milwaukie, OR 97222 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/05/2013 |
Last Update Date | 28/05/2013 |