NPI | 1346527512 |
---|---|
Former Name | DOREY MAY SWANSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: MN H6143) |
Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: WI 5943-16) |
Enumeration Date | 2011-11-15 |
Last Update Date | 2011-11-15 |