| NPI | 1184852188 |
|---|---|
| Former Name | DEBRA A MATTHEWS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: GA 9700) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS021298L) |
| Enumeration Date | 2009-06-29 |
| Last Update Date | 2009-06-29 |