| NPI | 1992952154 |
|---|---|
| Former Name | MARY LUELLA CARTER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: OK 159) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CA 60091) |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MD 15559) | |
| Enumeration Date | 2008-08-19 |
| Last Update Date | 2013-09-12 |