Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 010746 | CT |
NPI | 1063654101 |
---|---|
Provider Name | Maureen Elizabeth Wood |
First Address | Rochester, NY 14620 |
Second Address | Rochester, NY 14620 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2009 |
Last Update Date | 08/08/2014 |