Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist |
NPI | 1013417765 |
---|---|
Provider Name | Katharine Pfeifer |
First Address | Libby, MT 59923-2010 |
Second Address | Troy, MT 59935 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/02/2018 |
Last Update Date | 17/03/2018 |