| NPI | 1972290955 |
|---|---|
| Former Name | SUSANNA OLUWADUNNI OLOFINTUYI |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA DL15884) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MA DL15618) |
| Enumeration Date | 2023-04-20 |
| Last Update Date | 2023-09-07 |