Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 126800000X | Dental Assistant | NC |
NPI | 1174664387 |
---|---|
Provider Name | Deborah Tarter Duplain |
First Address | Conover, NC 28613 |
Second Address | Statesville, NC 28625 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/02/2007 |
Last Update Date | 08/07/2007 |