| NPI | 1619265907 |
|---|---|
| Other Name | BETH SUSAN MELENBRINK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MO 2012003057) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019028673) |
| Enumeration Date | 2011-07-20 |
| Last Update Date | 2017-03-13 |