Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | 30.025382 | OH |
NPI | 1619459880 |
---|---|
Provider Name | Dr. Jordyn Renee Hildebrand |
First Address | North Canton, OH 44720-2290 |
Second Address | North Canton, OH 44720-2290 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/09/2018 |
Last Update Date | 04/09/2018 |