Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | DN21223 | FL |
Y | 1223P0106X | Oral and Maxillofacial Pathology | DN21223 | FL |
NPI | 1043690977 |
---|---|
Provider Name | Evelyn Critchfield |
First Address | Naples, FL 34102-5128 |
Second Address | Naples, FL 34102-5128 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2015 |
Last Update Date | 09/05/2019 |