Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | F23236 | TX |
NPI | 1417145772 |
---|---|
Provider Name | Anneta Bitouni |
First Address | Dallas, TX 75246-2013 |
Second Address | Dallas, TX 75246-2013 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/10/2007 |
Last Update Date | 11/10/2007 |