NPI | 1194138362 |
---|---|
Former Name | MISTY D HAUNGS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MO 2014016657) |
Additional Taxonomies | 122300000X Dentist (Licence: MO 2014016657) |
Enumeration Date | 2014-06-05 |
Last Update Date | 2019-06-05 |