Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | DH18007 | FL |
NPI | 1003830480 |
---|---|
Provider Name | Jennifer Pintado |
First Address | St Cloud, FL 34769 |
Second Address | Kissimmee, FL 34744 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2006 |
Last Update Date | 08/07/2007 |