Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | 6467-016 | WI |
NPI | 1043220007 |
---|---|
Provider Name | Ms. Natalya S Zavarnova Bleichwehl |
First Address | Milwaukee, WI 53210-2246 |
Second Address | Milwaukee, WI 53204-2266 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/08/2006 |
Last Update Date | 08/07/2007 |