NPI | 1437129632 |
---|---|
Former Name | PENELOPE HENDRIX WOOD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 8132) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: FL DN10414) |
1223G0001X Dentist, General Practice (Licence: AL 3908) | |
Enumeration Date | 2006-01-23 |
Last Update Date | 2018-04-10 |