Individual
LENA LAURENTIK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3162 RICHMOND ST, PHILADELPHIA, PA 19134-5827
(215) 739-8008
(215) 739-8022
Mailing address
9613 DEDAKER ST, PHILADELPHIA, PA 19115-3112
(267) 902-5570
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
DH072197
PA
Other
Enumeration date
11/30/2020
Last updated
11/30/2020
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