NPI | 1821210196 |
---|---|
Professional Name | FORREST Q DUAN |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CA 38518) |
Additional Taxonomies | 1223P0700X Dentist, Prosthodontics (Licence: CA 38518) |
Enumeration Date | 2007-05-03 |
Last Update Date | 2023-08-21 |