NPI | 1578755948 |
---|---|
Other Name | DARRELL OSTERHOUDT |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223D0001X Dentist, Dental Public Health (Licence: UT 5138167-9922) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: UT H06158) |
Enumeration Date | 2007-08-09 |
Last Update Date | 2019-07-15 |