NPI | 1700240512 |
---|---|
Former Name | HEATHER ELIZABETH WASHBURN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: KY 9801) |
Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: IN 12012555A) |
Enumeration Date | 2016-04-07 |
Last Update Date | 2022-08-04 |