| NPI | 1306142815 |
|---|---|
| Former Name | JODY LYNN CHAPMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: MI 2901020339) |
| Additional Taxonomies | 122300000X Dentist (Licence: MI 2901020339) |
| Enumeration Date | 2011-01-31 |
| Last Update Date | 2018-03-17 |