| NPI | 1124114905 |
|---|---|
| Former Name | SHERRI BURGONIO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NV 5639) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: AZ 6972) |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2011-08-11 |