| NPI | 1265924096 |
|---|---|
| Former Name | KARISSA BURGOS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NV S3-393C) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CA 106073) |
| Enumeration Date | 2018-06-06 |
| Last Update Date | 2025-10-08 |