Individual
MRS. KATHLEEN MARY MARTIN LANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
419 BOSTON POST ROAD, WEST HAVEN, CT 06516-1918
(203) 931-6028
Mailing address
419 BOSTON POST ROAD, WEST HAVEN, CT 06516-1918
(203) 931-6028
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
006260
CT
Other
Enumeration date
03/04/2010
Last updated
03/04/2010
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