| NPI | 1841029113 |
|---|---|
| Former Name | JORDAN MICHELLE KANE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MO 2024029600) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: KS 62355) |
| Enumeration Date | 2024-07-26 |
| Last Update Date | 2026-07-27 |