| NPI | 1700830619 |
|---|---|
| Former Name | JENNIE JO HELM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MT 2304) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: AZ 6280) |
| 1223G0001X Dentist, General Practice (Licence: WA 7536) | |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2012-02-10 |