| NPI | 1043796428 |
|---|---|
| Former Name | ERIN HENDERSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: CO DEN.00204710) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019.031785) |
| 122300000X Dentist (Licence: CO 00204710) | |
| Enumeration Date | 2018-07-18 |
| Last Update Date | 2024-10-15 |