NPI | 1518113299 |
---|---|
Former Name | SUNNSHINE MARIE WELTON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 122300000X Dentist (Licence: ID D4715) |
Additional Taxonomies | 122300000X Dentist (Licence: ID 4715) |
Enumeration Date | 2008-08-13 |
Last Update Date | 2024-10-24 |