| NPI | 1427417070 |
|---|---|
| Former Name | JESSICA NICOLE HOUGHTON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: TN 11205) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 122300000X Dentist (Licence: NC 10747) | |
| Enumeration Date | 2016-02-10 |
| Last Update Date | 2020-12-18 |