| NPI | 1639456718 |
|---|---|
| Former Name | TINA MARIE SCOTT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 126800000X Dental Assistant |
| Additional Taxonomies | 126800000X Dental Assistant |
| Enumeration Date | 2011-11-03 |
| Last Update Date | 2011-11-03 |