| NPI | 1194189878 |
|---|---|
| Former Name | THANA DAWN TACHEENE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: AZ H06758) |
| Additional Taxonomies | 1223D0004X Dentist, Dentist Anesthesiologist Speciality (Licence: AZ 00087) |
| Enumeration Date | 2016-04-08 |
| Last Update Date | 2016-04-08 |