Individual
TRACE LANIER LYNN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
3107 MAPLEWOOD DR, SULPHUR, LA 70663-6201
(337) 625-9911
(337) 625-9912
Mailing address
3107 MAPLEWOOD DR, SULPHUR, LA 70663-6201
(337) 625-9911
(337) 625-9912
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
LA5970
LA
Other
Enumeration date
06/09/2009
Last updated
11/11/2015
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