Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | DS036395 | PA |
NPI | 1114190378 |
---|---|
Provider Name | Dr. Kristin M Jabbs |
First Address | Allentown, PA 18109-9120 |
Second Address | Allentown, PA 18109-9120 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/04/2008 |
Last Update Date | 09/04/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
DS036395 | DENTAL (01) | PA |