| NPI | 1518130228 |
|---|---|
| Former Name | TIFFANI ANN COTTER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: AR 3650) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: CA 47705) |
| Enumeration Date | 2008-04-02 |
| Last Update Date | 2008-04-28 |