| NPI | 1720063241 |
|---|---|
| Former Name | JENNIFER LYNN MILLS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: OR D8835) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS036047) |
| Enumeration Date | 2005-12-07 |
| Last Update Date | 2008-11-25 |