NPI | 1699174623 |
---|---|
Former Name | VALENTINA DEL VALLE MATA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 122300000X Dentist (Licence: FL 20502) |
Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: FL 20502) |
Enumeration Date | 2014-08-14 |
Last Update Date | 2019-09-16 |