Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | 103318 | CA |
NPI | 1013510932 |
---|---|
Provider Name | Meena Adami |
First Address | Redlands, CA 92373-4957 |
Second Address | Redlands, CA 92373-4957 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/11/2020 |
Last Update Date | 21/11/2020 |