| 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 |