Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | 08554 | IA |
NPI | 1063516060 |
---|---|
Provider Name | Dr. Kaaren Giselle Vargas |
First Address | North Liberty, IA 52317-2316 |
Second Address | North Liberty, IA 52317-2322 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/09/2006 |
Last Update Date | 11/01/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1184358 | (05) | IA |