Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | DN17610 | FL |
NPI | 1003987157 |
---|---|
Provider Name | Dr. Alyssa Hillman Pinnock |
First Address | Ft Lauderdale, FL 33315-1024 |
Second Address | Dania Beach, FL 33004-3212 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/11/2006 |
Last Update Date | 11/05/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
076731000 | (05) | FL |