NPI | 1700042546 |
---|---|
Former Name | RANAE STINE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 125K00000X Advanced Practice Dental Therapist (Licence: MN DT46) |
Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: MT 857) |
124Q00000X Dental Hygienist (Licence: MN H6057) | |
Enumeration Date | 2008-07-31 |
Last Update Date | 2024-08-29 |