| NPI | 1003270612 |
|---|---|
| Former Name | DOMINIQUE KNOX |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: VA 0401415681) |
| Additional Taxonomies | 122300000X Dentist (Licence: MD 16313) |
| 1223G0001X Dentist, General Practice (Licence: MD 16313) | |
| Enumeration Date | 2016-04-09 |
| Last Update Date | 2022-07-25 |