Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | 2006021705 | MO |
NPI | 1063663565 |
---|---|
Provider Name | Kristi Marie Dobbs |
First Address | Neosho, MO 64850-9120 |
Second Address | Anderson, MO 64831-9753 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2008 |
Last Update Date | 02/10/2008 |