| NPI | 1366555609 |
|---|---|
| Former Name | GEORGIA GRACE DELACRUZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: PA DS-028395-L) |
| Additional Taxonomies | 1223D0001X Dentist, Dental Public Health (Licence: PA DS-028395-L) |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2018-08-23 |