| NPI | 1629289129 |
|---|---|
| Former Name | LORETTA KAY FELDER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: SC SC2642) |
| Additional Taxonomies | 122300000X Dentist (Licence: GA DN013211) |
| 122300000X Dentist (Licence: VA 0401411265) | |
| Enumeration Date | 2007-05-25 |
| Last Update Date | 2007-07-08 |