NPI | 1841579059 |
---|---|
Former Name | STEPHANIE BROOKE SWORDS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: NC 300221) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 0027089) |
Enumeration Date | 2011-08-05 |
Last Update Date | 2022-03-16 |