Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | 2902010537 | MI |
NPI | 1003368648 |
---|---|
Provider Name | Cynthia Joslyn |
First Address | Lincoln Park, MI 48146-4020 |
Second Address | Taylor, MI 48180-4835 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/10/2016 |
Last Update Date | 31/10/2016 |