Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 126800000X | Dental Assistant | OH |
NPI | 1023415403 |
---|---|
Provider Name | Ms. Patricia Woolard |
First Address | Ft Wright, KY 41011-3723 |
Second Address | Ft Wright, KY 41011-3723 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/12/2014 |
Last Update Date | 01/12/2014 |