Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | 37062 | TX |
NPI | 1275209413 |
---|---|
Provider Name | Raghad Obeidat |
First Address | Plano, TX 75025-5735 |
Second Address | Plano, TX 75025-5735 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/08/2021 |
Last Update Date | 18/08/2021 |