NPI | 1558396671 |
---|---|
Former Name | DONNA C ROSS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 051750) |
Additional Taxonomies | 122300000X Dentist (Licence: NC 8025) |
1223G0001X Dentist, General Practice (Licence: NC 8025) | |
Enumeration Date | 2006-07-11 |
Last Update Date | 2022-05-16 |