| NPI | 1093060519 |
|---|---|
| Former Name | JESSICA FRANCES WILBERDING |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: NE 7045) |
| Additional Taxonomies | 122300000X Dentist (Licence: IA 08927) |
| Enumeration Date | 2012-07-20 |
| Last Update Date | 2012-10-30 |