| NPI | 1063490639 |
|---|---|
| Former Name | EDITH ANN JENNINGS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: CA CA56651) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: AZ 5253) |
| Enumeration Date | 2006-01-04 |
| Last Update Date | 2009-07-17 |