| NPI | 1891241303 |
|---|---|
| Former Name | KAYCEE CAROL DEJONG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223X0008X Dentist Oral and Maxillofacial Radiology (Licence: AZ D009579) |
| Enumeration Date | 2016-08-26 |
| Last Update Date | 2016-08-26 |