| 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 | 2023-03-30 |