| NPI | 1770876807 |
|---|---|
| Former Name | SHANA ALEXIS JONES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WI 6001116-15) |
| Additional Taxonomies | 122300000X Dentist (Licence: GA 2901020385) |
| Enumeration Date | 2011-05-23 |
| Last Update Date | 2023-02-23 |