NPI | 1134503428 |
---|---|
Former Name | ALICIA A CASTELLANO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: FL DN21373) |
Additional Taxonomies | 122300000X Dentist (Licence: FL DN 21373) |
Enumeration Date | 2015-07-16 |
Last Update Date | 2022-08-28 |