| NPI | 1649625518 |
|---|---|
| Former Name | LISA MARIE ATLAS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NC 10913) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: OH 30.024996) |
| Enumeration Date | 2016-04-28 |
| Last Update Date | 2023-10-10 |