NPI | 1982898482 |
---|---|
Former Name | MARIANNA KLYMUK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: PA DS036830) |
Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: PA DS036830) |
Enumeration Date | 2007-08-28 |
Last Update Date | 2016-06-08 |