| NPI | 1285887562 |
|---|---|
| Former Name | AMY LYNN RYNARD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: FL 18889) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: MO 15940) |
| 1223G0001X Dentist General Practice (Licence: KS 60586) | |
| Enumeration Date | 2008-10-30 |
| Last Update Date | 2014-09-03 |