Individual
MRS. LORI MARISA TERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDHAP
Contact information
Practice address
1512 ULLREY AVE, ESCALON, CA 95320-9658
(209) 610-0575
Mailing address
1512 ULLREY AVE, ESCALON, CA 95320-9658
(209) 610-0575
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
RDHAP 203
CA
Other
Enumeration date
02/13/2008
Last updated
02/13/2008
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