| NPI | 1932558657 |
|---|---|
| Former Name | REBECCA MARIE PADDACK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 100560) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2016-06-03 |
| Last Update Date | 2016-07-27 |