| NPI | 1083902936 |
|---|---|
| Former Name | KRISTIN MCCALLA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ D010245) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IL 019.028620) |
| Enumeration Date | 2011-07-13 |
| Last Update Date | 2022-06-06 |