| # |
Taxonomy Code |
Taxonomy |
License Number |
License Number State |
| 1 | 1223G0001X | General Practice Dentistry | 051116 | NY |
| 2 | 1223G0001X | General Practice Dentistry | D-3858 | ID |
| 3 | 1223G0001X | General Practice Dentistry | 22044 | OH |
| 4 | 1223G0001X | General Practice Dentistry | 12010429A | IN |
| 5 | 1223G0001X | General Practice Dentistry | 5641 | OK |
| 6 | 1223G0001X | General Practice Dentistry | 5641 | AZ |
| 7 | 1223G0001X | General Practice Dentistry | 4778T | NV |
| 8 | 1223G0001X | General Practice Dentistry | 60210 | KS |
| 9 | 1223G0001X | General Practice Dentistry | DD2043 | NM |
| 10 | 1223G0001X | General Practice Dentistry | 1134 | WY |
| 11 | 1223G0001X | General Practice Dentistry | 3209 | CO |
| 12 | 1223G0001X | General Practice Dentistry | 21280 | MA |