| NPI | 1083878896 |
|---|---|
| Former Name | JOLENE MARIE HERMES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IA DDS-08542) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IA 08542) |
| Enumeration Date | 2008-07-11 |
| Last Update Date | 2015-01-12 |