| NPI | 1528057619 |
|---|---|
| Former Name | MARIELLA BONILLA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: VA 0401418346) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: CO DEN.00205516) |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: MA 20376) | |
| Enumeration Date | 2005-10-20 |
| Last Update Date | 2025-08-29 |