NPI | 1710466727 |
---|---|
Former Name | VICTORIA LEIGH CASTENS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: DC DEN1002003) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MD 16638) |
Enumeration Date | 2018-08-09 |
Last Update Date | 2020-08-20 |