NPI | 1285723676 |
---|---|
Former Name | MICHELLE Y KURKOWSKI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: OR D9595) |
Additional Taxonomies | 122300000X Dentist (Licence: MI 2901019090) |
1223P0221X Dentist, Pediatric Dentistry (Licence: WA DE 60113228) | |
Enumeration Date | 2006-10-12 |
Last Update Date | 2014-02-19 |