NPI | 1710391511 |
---|---|
Former Name | ALYSSA VIGNERON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: HI DT-2843) |
Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CO DEN.00203333) |
Enumeration Date | 2014-06-19 |
Last Update Date | 2023-07-14 |