| NPI | 1639669815 |
|---|---|
| Former Name | KATHRYN JEAN SHERIDAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: VA 0401416478) |
| Additional Taxonomies | 122300000X Dentist (Licence: VA 1639669815) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-05-14 |
| Last Update Date | 2022-03-01 |