| NPI | 1790096584 |
|---|---|
| Former Name | JACQUELINE SIMANOVSKY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NJ 22DI02529300) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 055982) |
| Enumeration Date | 2010-06-25 |
| Last Update Date | 2019-01-28 |