Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 126800000X | Dental Assistant | 38966 | TX |
NPI | 1376053090 |
---|---|
Provider Name | Sarah Thrutchley |
First Address | Houston, TX 77042-1358 |
Second Address | Houston, TX 77042-1358 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/10/2017 |
Last Update Date | 08/10/2017 |