Individual
MS. LAUREEN JANEL TICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
400 SW BEL AIR DR., CLATSKANIE, OR 97016
(503) 728-2114
(503) 728-3322
Mailing address
P.O. BOX 749, CLATSKANIE, OR 97016
(503) 728-2114
(503) 728-3320
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
H3408
OR
Other
Enumeration date
10/07/2014
Last updated
02/02/2015
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