| NPI | 1316359813 |
|---|---|
| Former Name | HEATHER DREBITKO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: NV 6896) |
| Additional Taxonomies | 122300000X Dentist (Licence: TX 29898) |
| Enumeration Date | 2014-06-02 |
| Last Update Date | 2017-05-09 |