NPI | 1063941961 |
---|---|
Former Name | JANE K WHITE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: KY 9926) |
Additional Taxonomies | 122300000X Dentist (Licence: KY 9926) |
Enumeration Date | 2017-06-06 |
Last Update Date | 2020-06-17 |