Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 14303 | MI |
NPI | 1144252768 |
---|---|
Provider Name | Mary K Mcneight |
First Address | Livonia, MI 48150-1819 |
Second Address | Livonia, MI 48150-1819 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2006 |
Last Update Date | 08/07/2007 |