NPI | 1285792614 |
---|---|
Former Name | FAITH ANGELICA VENTURA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401414157) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NM DD1937) |
Enumeration Date | 2006-12-05 |
Last Update Date | 2018-03-17 |