| NPI | 1912383217 |
|---|---|
| Professional Name | JESSICA SCULLY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: MO 2015023903) |
| Additional Taxonomies | 122300000X Dentist (Licence: MO 2015023903) |
| Enumeration Date | 2015-08-10 |
| Last Update Date | 2018-11-12 |