| NPI | 1023118403 |
|---|---|
| Former Name | VIRGINIA POTTER THOMAS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: TX 25974) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA DI035732) |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2015-04-10 |