Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist |
NPI | 1073633061 |
---|---|
Provider Name | Mrs. Tamekia Yvonne Davis |
First Address | Upper Marlboro, MD 20772-6140 |
Second Address | Upper Marlboro, MD 20772-6140 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/03/2007 |
Last Update Date | 24/08/2007 |