NPI | 1174947964 |
---|---|
Former Name | CANDICE CORTE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 30067) |
Additional Taxonomies | 122300000X Dentist (Licence: TX 000000000) |
Enumeration Date | 2014-02-13 |
Last Update Date | 2018-04-23 |