NPI | 1811251036 |
---|---|
Former Name | LEANNA CHRISTINE ASSID |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: PA DS039199) |
Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: SC 8184) |
Enumeration Date | 2012-07-02 |
Last Update Date | 2024-02-19 |