Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 126800000X | Dental Assistant | 208546 | NC |
NPI | 1104442227 |
---|---|
Provider Name | Amber Goodman Brigman |
First Address | Asheville, NC 28805-1616 |
Second Address | Asheville, NC 28805-1616 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2020 |
Last Update Date | 24/06/2020 |