| 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 |