Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 126800000X | Dental Assistant | 11638 | TX |
NPI | 1386038529 |
---|---|
Provider Name | Patricia Garcia-Perry |
First Address | Dallas, TX 75219-4709 |
Second Address | Dallas, TX 75219-4709 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/03/2015 |
Last Update Date | 25/03/2015 |