Individual
LORI WOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHDHP
Contact information
Practice address
600 MAPLE AVE STE 7, HONESDALE, PA 18431-1460
(570) 251-6534
Mailing address
601 PARK ST, HONESDALE, PA 18431-1445
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
DH012837L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DH012837L
DENTAL HYGIENIST
PA
01
—
PHDH000222
PHDHP LICENSE
PA
Enumeration date
08/09/2017
Last updated
08/09/2017
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