NPI | 1144663956 |
---|---|
Former Name | JOCELYNN MARIE ORTEGA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: CA 63888) |
Additional Taxonomies | 122300000X Dentist (Licence: FL DN20253) |
Enumeration Date | 2013-04-10 |
Last Update Date | 2014-11-17 |