| NPI | 1679093058 |
|---|---|
| Former Name | MOLLY DELORA BERKE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: IA DDS-09735) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NE 7516) |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: SD D1261) | |
| Enumeration Date | 2017-06-26 |
| Last Update Date | 2020-06-24 |