Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 126800000X | Dental Assistant | ||
Y | 126800000X | Dental Assistant | WA |
NPI | 1134739881 |
---|---|
Provider Name | Bryonna Floyd |
First Address | Joint Base Lewis-Mcchord, WA 98433 |
Second Address | Joint Base Lewis-Mcchord, WA 98433 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/08/2020 |
Last Update Date | 07/08/2020 |