| NPI | 1245960012 |
|---|---|
| Former Name | MCKENNA JO KILBURG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223D0001X Dentist, Dental Public Health (Licence: IA DDS-09995) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IA DDS-09995) |
| Enumeration Date | 2022-06-14 |
| Last Update Date | 2024-04-09 |