NPI | 1083144265 |
---|---|
Former Name | KELLY BEGLIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: OH 30.025993) |
Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: KY 9976) |
Enumeration Date | 2017-06-19 |
Last Update Date | 2024-07-02 |