Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | 30022533 | OH |
NPI | 1003011123 |
---|---|
Provider Name | Yoon-Mi Matracia |
First Address | Dublin, OH 43016-9335 |
Second Address | Dublin, OH 43017-2155 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/06/2007 |
Last Update Date | 22/02/2013 |