Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 126800000X | Dental Assistant |
NPI | 1154980589 |
---|---|
Provider Name | Laima Astrauskas |
First Address | Eugene, OR 97401-2127 |
Second Address | Eugene, OR 97401-2127 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2019 |
Last Update Date | 10/06/2019 |