| NPI | 1356967079 |
|---|---|
| Former Name | JACY R GLOVER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OK 7301) |
| Additional Taxonomies | 122300000X Dentist (Licence: OK T7301) |
| 122300000X Dentist (Licence: OK 7301) | |
| Enumeration Date | 2020-06-18 |
| Last Update Date | 2025-08-25 |