| NPI | 1982697660 |
|---|---|
| Former Name | ALICIA DEANN GUTH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: GA DN015359) |
| Additional Taxonomies | 122300000X Dentist (Licence: TX 24199) |
| 122300000X Dentist (Licence: MD 12134) | |
| Enumeration Date | 2005-08-26 |
| Last Update Date | 2020-04-23 |