Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | 21464 | TX |
NPI | 1093819096 |
---|---|
Provider Name | Yoneida Calogero |
First Address | Alice, TX 78333 |
Second Address | Alice, TX 78332 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/09/2006 |
Last Update Date | 08/07/2007 |