Individual
LAUREN MAMMINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
13219 EUREKA RD, SOUTHGATE, MI 48195-1309
(734) 441-0200
Mailing address
1307 N ALEXANDER AVE, ROYAL OAK, MI 48067-3652
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
290102303
MI
Other
Enumeration date
07/23/2019
Last updated
07/23/2019
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