Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | DN23882 | FL |
NPI | 1073044087 |
---|---|
Provider Name | Jennifer J. Sylvian |
First Address | Lauderdale Lakes, FL 33309-5407 |
Second Address | South Bay, FL 33493-2213 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/03/2017 |
Last Update Date | 13/06/2019 |