NPI | 1134509813 |
---|---|
Other Name | OLIVIA BASS COOK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: MS 3889-16) |
Additional Taxonomies | 122300000X Dentist (Licence: OH 30.024519) |
1223E0200X Dentist, Endodontics (Licence: MS ENDO-537-17) | |
Enumeration Date | 2015-06-08 |
Last Update Date | 2019-04-30 |