Individual
MRS. REBECCA ANN LAVENE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D
Contact information
Practice address
2152 MCCULLOCH BLVD N STE C, LAKE HAVASU CITY, AZ 86403-6805
(310) 947-2631
(310) 947-2631
Mailing address
2152 MCCULLOCH BLVD N STE C, LAKE HAVASU CITY, AZ 86403-6805
(928) 854-5551
(928) 733-6128
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
8823
AZ
Other
Enumeration date
09/29/2008
Last updated
10/22/2019
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