Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 126800000X | Dental Assistant |
NPI | 1285610725 |
---|---|
Provider Name | Mrs. Leigh C Lykins |
First Address | Juneau, AK 99803-2236 |
Second Address | Juneau, AK 99801-1807 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/12/2005 |
Last Update Date | 08/07/2007 |