| NPI | 1730477167 |
|---|---|
| Former Name | MARY KAY CANIGLIA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IA 08963) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: OR D9602) |
| Enumeration Date | 2011-07-19 |
| Last Update Date | 2012-09-28 |