NPI | 1932414265 |
---|---|
Former Name | DAWNYETTA R MARABLE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: GA DN014150) |
Additional Taxonomies | 122300000X Dentist (Licence: GA DN014150) |
Enumeration Date | 2010-08-11 |
Last Update Date | 2024-08-13 |