Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | 37139 | TX |
NPI | 1043592314 |
---|---|
Provider Name | Dr. Anne Caitlin Mclean-Holden |
First Address | Dallas, TX 75390-0001 |
Second Address | Dallas, TX 75390-4887 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2011 |
Last Update Date | 17/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
DD3602 | NEW MEXICO LICENSING AND REGULATIONS (01) | NM |