| NPI | 1639691462 |
|---|---|
| Former Name | MARGARET MADISON SPACH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: CT 14095) |
| Additional Taxonomies | 122300000X Dentist (Licence: MD 16393) |
| 122300000X Dentist (Licence: NC 11775) | |
| Enumeration Date | 2017-07-13 |
| Last Update Date | 2024-06-21 |