NPI | 1932317922 |
---|---|
Former Name | JODI EVE FAIR |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: FL DN17658) |
Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 24122) |
Enumeration Date | 2007-05-21 |
Last Update Date | 2024-10-09 |