Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | D9729 | OR |
N | 122300000X | Dentist | DE60571710 | WA |
N | 1223D0001X | Dental Public Health | 6819 | NC |
NPI | 1285677799 |
---|---|
Provider Name | Dr. Jane Malin Espeseth |
First Address | Colorado Springs, CO 80903-1708 |
Second Address | Lincoln City, OR 97367-5128 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2006 |
Last Update Date | 16/01/2019 |