NPI | 1770677221 |
---|---|
Former Name | MELANIE SHEILS VERGELDT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: MI 2901016594) |
Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: MI 16594) |
Enumeration Date | 2006-10-02 |
Last Update Date | 2019-06-27 |