| NPI | 1770775652 |
|---|---|
| Former Name | JENNIFER LYNN ELZINGA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: OR D8979) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: OR D8979) |
| Enumeration Date | 2007-08-14 |
| Last Update Date | 2022-09-19 |