| NPI | 1538608013 | 
|---|---|
| Former Name | TIFFANY DENISE CHOAT | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: GA DH012401) | 
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: TX 20420) | 
| Enumeration Date | 2017-02-17 | 
| Last Update Date | 2017-02-17 |