| NPI | 1306194931 |
|---|---|
| Former Name | MARI ROSE BEITMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: MT 6086) |
| Additional Taxonomies | 122300000X Dentist (Licence: UT 8331302-9922) |
| Enumeration Date | 2012-08-29 |
| Last Update Date | 2023-04-19 |