NPI | 1679197388 |
---|---|
Former Name | KRISTIN ANN SIMBOSKI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CO DEN.00204480) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CO T-DEN.00000021) |
Enumeration Date | 2020-05-29 |
Last Update Date | 2022-03-02 |