NPI | 1396408670 |
---|---|
Former Name | SAMANTHA KAY (REMOVE) EVANS (REMOVE) |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: TX 37933) |
Enumeration Date | 2021-10-14 |
Last Update Date | 2024-11-13 |