Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 8284 | NC |
N | 1223D0001X | Dental Public Health | 8804 | NC |
NPI | 1457435158 |
---|---|
Provider Name | Dr. Sandra Barlow-Doonquah |
First Address | Reidsville, NC 27320-9608 |
Second Address | Reidsville, NC 27320-5900 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2006 |
Last Update Date | 29/10/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8284 | DENTAL LICENSE (01) | NC |
89902H6 | (05) | NC |