| 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 |