NPI | 1902067077 |
---|---|
Former Name | CARMEL ZAWIDEH DUDLEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OR D9708) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MA 22066) |
Enumeration Date | 2008-06-21 |
Last Update Date | 2018-05-15 |