| NPI | 1073181327 |
|---|---|
| Former Name | TRACY PEITZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: NE 7726) |
| Additional Taxonomies | 122300000X Dentist (Licence: NE 7726) |
| Enumeration Date | 2021-06-14 |
| Last Update Date | 2024-07-25 |