| NPI | 1013357979 |
|---|---|
| Former Name | KAITLIN JEAN POPPE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: WA 60379179) |
| Additional Taxonomies | 122300000X Dentist (Licence: WA 60379179) |
| Enumeration Date | 2013-06-25 |
| Last Update Date | 2023-04-25 |