Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | 9759-016 | WI |
NPI | 1033367685 |
---|---|
Provider Name | Toni L Montez |
First Address | Bowler, WI 54416-9551 |
Second Address | Bowler, WI 54416-9551 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/09/2008 |
Last Update Date | 08/09/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
33828800 | (05) | WI |