Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 126800000X | Dental Assistant | 1388 | CA |
NPI | 1235377706 |
---|---|
Provider Name | Makeda R Jones |
First Address | Paramount, CA 90723-2687 |
Second Address | Hawthorne, CA 90250-3919 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/01/2009 |
Last Update Date | 21/01/2009 |