Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 1857505 | MA |
N | 1223X0400X | Orthodontists | 9864 | NC |
NPI | 1013314244 |
---|---|
Provider Name | Karla Maria Alvarado |
First Address | Plymouth, MA 02360 |
Second Address | Plymouth, MA 02360-2670 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/12/2014 |
Last Update Date | 08/03/2018 |