NPI | 1144641697 |
---|---|
Former Name | CHAD MICHAEL ALLRED |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CA 63193) |
Enumeration Date | 2014-01-01 |
Last Update Date | 2023-03-07 |