Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 126800000X | Dental Assistant | A12420 | MN |
NPI | 1053587410 |
---|---|
Provider Name | Ms. Sara Elizabeth Bell |
First Address | Woodbury, MN 55125-3910 |
Second Address | Woodbury, MN 55125-3910 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/05/2008 |
Last Update Date | 06/05/2008 |