Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 0401413487 | VA |
NPI | 1023247269 |
---|---|
Provider Name | Dr. Holly Renee Eppard |
First Address | Culpeper, VA 22701-3378 |
Second Address | Culpeper, VA 22701-3378 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/07/2009 |
Last Update Date | 28/08/2014 |