NPI | 1508208059 |
---|---|
Former Name | RACHEL E. MISURACA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: KY 10198) |
Additional Taxonomies | 122300000X Dentist (Licence: MA DN1856268) |
Enumeration Date | 2013-07-25 |
Last Update Date | 2024-10-18 |