| NPI | 1083932230 |
|---|---|
| Former Name | SAMANTHA ROACH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: MN D13028) |
| Additional Taxonomies | 122300000X Dentist (Licence: MN R448) |
| Enumeration Date | 2010-05-12 |
| Last Update Date | 2020-12-02 |