Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 126800000X | Dental Assistant | 193555 | OH |
NPI | 1053716316 |
---|---|
Provider Name | Joann Cox |
First Address | Cincinnati, OH 45238-5824 |
Second Address | Cincinnati, OH 45223-3302 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/10/2014 |
Last Update Date | 29/10/2014 |