| NPI | 1992051098 |
|---|---|
| Former Name | MICHELLE LYNNE FELLINGER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 126800000X Dental Assistant (Licence: CA RDA63963) |
| Additional Taxonomies | 126800000X Dental Assistant (Licence: CA 63963) |
| Enumeration Date | 2012-07-26 |
| Last Update Date | 2012-07-26 |