Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 126800000X | Dental Assistant |
NPI | 1316349418 |
---|---|
Provider Name | Sara Bewsey |
First Address | Covington, KY 41011-3463 |
Second Address | Cincinnati, OH 45229-3014 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/09/2014 |
Last Update Date | 19/09/2014 |