Individual
LISA MARIE GORTARI
Active
Individual
LISA MARIE GORTARI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
27675
TX
122300000X
Dentist
59423
CA
122300000X
Dentist
D008600
AZ
1223D0004X
Dental Anesthesiology
Primary
27675
TX
1223D0004X
Dental Anesthesiology
59423
CA
1223D0004X
Dental Anesthesiology
D008600
AZ
Other
Enumeration date
09/17/2010
Last updated
01/20/2016
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