NPI | 1225121742 |
---|---|
Former Name | TENNILLE LYNN CHEEK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: OK 5599) |
Additional Taxonomies | 122300000X Dentist (Licence: KY 7911) |
Enumeration Date | 2006-10-02 |
Last Update Date | 2012-01-04 |