Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 11721 | MN |
NPI | 1033263660 |
---|---|
Provider Name | Dr. Heather M. Carr |
First Address | Apple Valley, MN 55124-7545 |
Second Address | Plymouth, MN 55447-1540 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/01/2007 |
Last Update Date | 08/07/2007 |