| NPI | 1104448190 |
|---|---|
| Former Name | JESSICA GRACE GASSER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: KY 10982) |
| Additional Taxonomies | 122300000X Dentist (Licence: HI 2864) |
| Enumeration Date | 2020-05-12 |
| Last Update Date | 2025-04-08 |