| NPI | 1528553732 |
|---|---|
| Former Name | ABBY MCCLELLAN KERBAUGH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 40837) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TN 10782) |
| 1223G0001X Dentist, General Practice (Licence: KY 10574) | |
| Enumeration Date | 2018-06-29 |
| Last Update Date | 2024-11-18 |