Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 126800000X | Dental Assistant |
NPI | 1093827495 |
---|---|
Provider Name | Sheila K Miskuf |
First Address | Bedford, IN 47421-5288 |
Second Address | Bedford, IN 47421-5288 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 08/07/2007 |