NPI | 1841675030 |
---|---|
Former Name | DANIELLE ELIZABETH EASTERLY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: VA 0401415564) |
Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: VA 0442000240) |
Enumeration Date | 2015-07-29 |
Last Update Date | 2022-07-21 |