| NPI | 1386903631 |
|---|---|
| Former Name | HEATHER LENORE MCBURNETT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: HI 2504) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 1223D0001X Dentist, Dental Public Health (Licence: HI 195) | |
| Enumeration Date | 2012-05-07 |
| Last Update Date | 2013-03-24 |