Individual
JACQUELYN FAITH PROULX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
1 PICKNEY BLVD., NAVAL HOSPITAL BEAUFORT, BEAUFORT, SC 29902
(941) 345-6180
Mailing address
2030 ELMEN ST, HOUSTON, TX 77019-6107
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DEN.00202643
CO
Other
Enumeration date
09/16/2015
Last updated
09/16/2015
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