| NPI | 1962012450 |
|---|---|
| Former Name | JANE MARIE SMITH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 36517) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: LA 7098) |
| Enumeration Date | 2020-08-09 |
| Last Update Date | 2020-08-09 |