NPI | 1548258056 |
---|---|
Former Name | RUTH ELAINE ROSS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: TN DS0000007624) |
Enumeration Date | 2005-10-10 |
Last Update Date | 2010-10-04 |