Individual
JAZMINE MARIE WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
4041 N CENTRAL AVE BLDG C, PHOENIX, AZ 85012-3313
(602) 279-5262
Mailing address
3345 E BRANHAM LN, PHOENIX, AZ 85042-0008
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
H010646
AZ
Other
Enumeration date
03/25/2024
Last updated
03/25/2024
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