NPI | 1568442622 |
---|---|
Former Name | RACHELLE MARIE SMITH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OH 30.026285) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MT 2056) |
1223G0001X Dentist, General Practice (Licence: LA 5698) | |
1223G0001X Dentist, General Practice (Licence: FL DN25639) | |
Enumeration Date | 2006-01-17 |
Last Update Date | 2023-02-13 |