Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | DH2610 | OH |
NPI | 1013330471 |
---|---|
Provider Name | Margaret Mansur |
First Address | Columbus, OH 43211-1647 |
Second Address | Marion, OH 43302-8683 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/01/2014 |
Last Update Date | 21/01/2014 |