| NPI | 1467908814 |
|---|---|
| Former Name | KELLY LAUREN GRIFFITH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NC 10574) |
| Additional Taxonomies | 122300000X Dentist (Licence: NC 151098) |
| Enumeration Date | 2016-08-26 |
| Last Update Date | 2022-07-21 |