| NPI | 1932690195 |
|---|---|
| Former Name | JESSICA ANNA TINGEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: UT 10842218-9922) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: UT 10842218-9922) |
| Enumeration Date | 2018-05-23 |
| Last Update Date | 2018-05-23 |