| NPI | 1003045469 |
|---|---|
| Former Name | LETA CLENDENEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OK 6460) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NM DD3238) |
| Enumeration Date | 2009-07-07 |
| Last Update Date | 2014-03-19 |