NPI | 1770367146 |
---|---|
Former Name | STEPHANIE DEE TAYLOR |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: FL DN28577) |
Additional Taxonomies | 122300000X Dentist (Licence: FL DRPM2610) |
Enumeration Date | 2023-08-24 |
Last Update Date | 2023-09-27 |