| NPI | 1962649715 |
|---|---|
| Former Name | JESSICA LYNN HOLLERON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: NV 102237) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: CA 25954) |
| 124Q00000X Dental Hygienist (Licence: CA HAP542) | |
| 126800000X Dental Assistant (Licence: CA 64252) | |
| Enumeration Date | 2009-01-15 |
| Last Update Date | 2017-03-28 |