Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 047004 | NY |
NPI | 1003998972 |
---|---|
Provider Name | Dr. Jennifer Lea Bempkins |
First Address | Horseheads, NY 14845-8124 |
Second Address | Horseheads, NY 14845-8124 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/10/2006 |
Last Update Date | 12/09/2007 |