Individual
JIMMIE LORETTA LAWRENCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
221 3RD ST W, RANDOLPH AFB, TX 78150-4800
(210) 748-0314
Mailing address
221 3RD ST W, RANDOLPH AFB, TX 78150-4800
(210) 652-5515
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
13340
TX
Other
Enumeration date
08/09/2023
Last updated
08/09/2023
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