Individual
JESSICA J OVERTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
61 DELANO ST, PULASKI, NY 13142-1400
(315) 298-6815
(315) 298-7488
Mailing address
61 DELANO ST, PULASKI, NY 13142-1400
(315) 298-6815
(315) 298-7488
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
023797
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00023797
—
NY
Enumeration date
08/21/2009
Last updated
08/21/2009
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