| NPI | 1952142796 |
|---|---|
| Former Name | MASON LEE GARDELLA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: FL DN29008) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: FL DN29008) |
| Enumeration Date | 2024-06-05 |
| Last Update Date | 2025-05-14 |