Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | 8945 | NC |
NPI | 1295055127 |
---|---|
Provider Name | Dr. Carol Ann Iglesia |
First Address | Carrboro, NC 27510-1823 |
Second Address | Carrboro, NC 27510-1823 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/06/2010 |
Last Update Date | 02/06/2010 |