NPI | 1255744926 |
---|---|
Former Name | AMANDA ASHLEY STONE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223D0001X Dentist, Dental Public Health (Licence: MA DN1856563) |
Additional Taxonomies | 122300000X Dentist (Licence: MA DN1856563) |
Enumeration Date | 2014-06-10 |
Last Update Date | 2016-11-02 |