NPI | 1588911572 |
---|---|
Former Name | ALYSE GRANT DASON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: VA 0401413720) |
Additional Taxonomies | 122300000X Dentist (Licence: VA 0401413720) |
Enumeration Date | 2012-08-08 |
Last Update Date | 2025-06-10 |