Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 31094 | TX |
N | 1223P0700X | Prosthodontist | 3995 | ZZ |
NPI | 1245596279 |
---|---|
Provider Name | Dr. Hanife Canan Bayraktaroglu |
First Address | Minneapolis, MN 55486 |
Second Address | Lake Worth, TX 76135-2627 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2012 |
Last Update Date | 14/03/2016 |