| NPI | 1801214614 | 
|---|---|
| Former Name | MICHELL HUDDLESTON | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: OK 2761)  | 
| Additional Taxonomies | 124Q00000X Dental Hygienist | 
| Enumeration Date | 2014-03-31 | 
| Last Update Date | 2014-04-01 |