| NPI | 1386389690 |
|---|---|
| Former Name | AMANDA PAIGE CRUMMETT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: SC 10401) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 122300000X Dentist (Licence: IN 12013783A) | |
| Enumeration Date | 2022-05-02 |
| Last Update Date | 2023-02-13 |