Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | 047550 | NY |
NPI | 1013094929 |
---|---|
Provider Name | Lawrence Limb |
First Address | Woonsocket, RI 02895 |
Second Address | New York, NY 10023-5882 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 15/07/2009 |