Individual
DR. LISA KAY PORAPAIBOON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
3012 W FULLERTON AVE, CHICAGO, IL 60647-2808
(303) 587-6498
(773) 384-3500
Mailing address
3012 W FULLERTON AVE, CHICAGO, IL 60647-2808
(303) 587-6498
(773) 384-3500
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
8761
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
98608771
—
CO
Enumeration date
04/26/2007
Last updated
05/29/2009
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