Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 126800000X | Dental Assistant |
NPI | 1083287494 |
---|---|
Provider Name | Maria M Miller |
First Address | Fallon, NV 89406-3491 |
Second Address | Fallon, NV 89406-3491 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/07/2021 |
Last Update Date | 22/07/2021 |