NPI | 1740476472 |
---|---|
Former Name | EMILY REBECCA TOLLEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 122300000X Dentist (Licence: OH 30-022492) |
Additional Taxonomies | 1223P0700X Dentist, Prosthodontics (Licence: OH 30022492) |
1223P0700X Dentist, Prosthodontics (Licence: OH 30-022492) | |
Enumeration Date | 2007-09-17 |
Last Update Date | 2011-12-02 |