| NPI | 1396150710 |
|---|---|
| Former Name | WHITNEY KITCHELL LAVERTY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: OR D11417) |
| Additional Taxonomies | 122300000X Dentist (Licence: IN 12012156a) |
| 122300000X Dentist (Licence: CO DEN00202841) | |
| Enumeration Date | 2014-06-24 |
| Last Update Date | 2021-10-12 |