NPI | 1962797217 |
---|---|
Other Name | A JORDAN PRIESTLEY |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA 100101) |
Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 29673) |
1223P0221X Dentist, Pediatric Dentistry (Licence: WI 1001035) | |
Enumeration Date | 2011-06-15 |
Last Update Date | 2018-04-25 |