Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | IL |
NPI | 1033396460 |
---|---|
Provider Name | Mrs. Lourdes N Nogoy |
First Address | Wadsworth, IL 60083-8938 |
Second Address | Gurnee, IL 60031-5908 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/01/2008 |
Last Update Date | 29/01/2008 |