Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 23399 | TX |
NPI | 1003013301 |
---|---|
Provider Name | Dr. Valerie Mariana Santiago-Doyle |
First Address | Austin, TX 78739-1424 |
Second Address | Austin, TX 78749-6527 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2007 |
Last Update Date | 27/04/2015 |