| NPI | 1053705517 |
|---|---|
| Former Name | MELANIE VENTOCILLA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: VA 0401414660) |
| Additional Taxonomies | 122300000X Dentist (Licence: VA 0401414660) |
| Enumeration Date | 2015-03-23 |
| Last Update Date | 2025-03-10 |