| NPI | 1750086229 |
|---|---|
| Former Name | PEYTON LEBLANC |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 0741) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2023-04-03 |
| Last Update Date | 2024-07-09 |