Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | DH007190L | PA |
NPI | 1033564091 |
---|---|
Provider Name | Laurie Ann Drogus |
First Address | Beaver Falls, PA 15010-1020 |
Second Address | Beaver Falls, PA 15010-1061 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/04/2016 |
Last Update Date | 27/04/2016 |