| NPI | 1700777695 |
|---|---|
| Former Name | MADYSON ANGLIM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: IL 018.002326) |
| Enumeration Date | 2025-07-10 |
| Last Update Date | 2025-07-10 |