NPI | 1003398850 |
---|---|
Former Name | BAILEY MOORHEAD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: PA DS041939) |
Additional Taxonomies | 122300000X Dentist (Licence: PA DS041939) |
Enumeration Date | 2018-08-29 |
Last Update Date | 2023-08-29 |