| NPI | 1457508764 |
|---|---|
| Professional Name | RENEE POURTEMOUR |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 58649) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY 054067-1) |
| 1223G0001X Dentist, General Practice (Licence: NY 054067-1) | |
| Enumeration Date | 2008-08-19 |
| Last Update Date | 2018-03-23 |