| NPI | 1295148807 |
|---|---|
| Former Name | AMANDA KILBURN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NC 11271) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: VA 0401415217) |
| Enumeration Date | 2014-06-11 |
| Last Update Date | 2021-01-28 |