| NPI | 1760905665 |
|---|---|
| Former Name | JESSICA A WHITE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IL 019033913) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: OR D10695) |
| Enumeration Date | 2017-07-23 |
| Last Update Date | 2025-07-11 |