NPI | 1689701740 |
---|---|
Former Name | AMANDA NICOLE ESTEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IA 08596) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IL 019027098) |
Enumeration Date | 2007-02-27 |
Last Update Date | 2009-01-22 |