| NPI | 1104884774 |
|---|---|
| Former Name | SUZANNE BIRD DAVIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NC 7109) |
| Additional Taxonomies | 122300000X Dentist (Licence: NC 7109) |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NC 7109) | |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2013-07-18 |