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Individual
LAJUAN M MOUNTAIN
Active
Individual
LAJUAN M MOUNTAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS036195
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101296402
—
PA
01
—
169245
UNISON
PA
01
—
1734162
UNITED CONCORDIA
PA
01
—
248134
DENTAL BENEFIT PROVIDERS
PA
01
—
9179591
DORAL DENTAL
PA
01
—
DS036195
DELTA DENTAL
PA
Enumeration date
06/02/2006
Last updated
08/31/2011
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