| NPI | 1689985921 |
|---|---|
| Former Name | KATHLEEN ANNE VANVORST |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 35643) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 055950) |
| Enumeration Date | 2010-07-01 |
| Last Update Date | 2021-05-20 |