| NPI | 1225009756 |
|---|---|
| Former Name | JENNIFER FALLON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: RI 02949) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MA 21116) |
| Enumeration Date | 2006-02-01 |
| Last Update Date | 2018-06-27 |