| NPI | 1992238349 |
|---|---|
| Former Name | CAITLIN MARIE POWELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: KS 61323) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS041599) |
| 122300000X Dentist (Licence: MO 2018002595) | |
| Enumeration Date | 2017-04-04 |
| Last Update Date | 2019-05-29 |