Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 126800000X | Dental Assistant | 2936546 | PA |
NPI | 1245993583 |
---|---|
Provider Name | Katarina Hauben |
First Address | Yardley, PA 19067-3329 |
Second Address | Yardley, PA 19067-3329 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/10/2021 |
Last Update Date | 13/10/2021 |