NPI | 1609989342 |
---|---|
Former Name | ANDREA LENETTE WHITE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: TX 24150) |
Additional Taxonomies | 122300000X Dentist (Licence: AL LNO 5490) |
122300000X Dentist (Licence: AL 5490) | |
Enumeration Date | 2006-08-16 |
Last Update Date | 2016-03-01 |