Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | 2902017398 | MI |
NPI | 1013379106 |
---|---|
Provider Name | Rosemarie Martin |
First Address | Saginaw, MI 48601-5805 |
Second Address | Saginaw, MI 48601-5805 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/03/2016 |
Last Update Date | 28/03/2016 |