Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | 960 | MT |
NPI | 1003080441 |
---|---|
Provider Name | Ms. Barbara Ann Jones Deveraux |
First Address | Billings, MT 59106-4113 |
Second Address | Billings, MT 59101-1900 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/04/2008 |
Last Update Date | 13/01/2011 |