NPI | 1861684003 |
---|---|
Former Name | ANASTASIA LIANNE DODSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 122300000X Dentist (Licence: NV 6054) |
Additional Taxonomies | 122300000X Dentist (Licence: WA DE00011095) |
122300000X Dentist (Licence: CO 9564) | |
Enumeration Date | 2007-08-12 |
Last Update Date | 2014-08-27 |