NPI | 1902979628 |
---|---|
Other Name | KELLY BLAIR CREASY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 27548) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WA DE00010345) |
Enumeration Date | 2006-11-17 |
Last Update Date | 2018-05-08 |