NPI | 1962417733 |
---|---|
Former Name | SHAMAYNE MARIA DOSE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IA 08224) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NE 6431) |
1223G0001X Dentist, General Practice (Licence: SD M999) | |
Enumeration Date | 2006-07-30 |
Last Update Date | 2011-01-28 |