Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | DH87096 | MA |
NPI | 1013226505 |
---|---|
Provider Name | Jennifer Soito |
First Address | Taunton, MA 02780-4752 |
Second Address | Natick, MA 01760-4366 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/09/2010 |
Last Update Date | 04/11/2010 |