| NPI | 1174771802 |
|---|---|
| Former Name | SIOBHIAN MELINDA BACCHUS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: MA DN1857887) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: VA 0401412318) |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: DC DEN1000855) | |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: MD 15112) | |
| Enumeration Date | 2008-09-06 |
| Last Update Date | 2020-07-21 |