| NPI | 1083926174 |
|---|---|
| Former Name | DANA MARIE KOSSICK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TN 11655) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA 59164) |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 26045) | |
| Enumeration Date | 2010-07-06 |
| Last Update Date | 2024-09-18 |