| NPI | 1437597598 |
|---|---|
| Former Name | CARMEN NORA VILLASANTE MERCADO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: IL 021.002792) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: IL 019.031010) |
| 1223P0300X Dentist, Periodontics (Licence: TX 32052) | |
| 1223P0300X Dentist, Periodontics (Licence: ZZ 22154) | |
| Enumeration Date | 2013-06-11 |
| Last Update Date | 2022-06-06 |