Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | 2323 | NH |
NPI | 1003832593 |
---|---|
Provider Name | Mrs. Mary J Billings |
First Address | Sunapee, NH 03782-2818 |
Second Address | Lebanon, NH 03766-1358 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2323 | RDH (01) | NH |