Individual
MRS. JENNA WALSWORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.D.H.
Contact information
Practice address
6010 W AMARILLO BLVD, AMARILLO, TX 79106-1990
(318) 663-2558
Mailing address
5901 QUARRY ST, AMARILLO, TX 79124-3008
(318) 663-2558
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
19279
TX
Other
Enumeration date
07/25/2014
Last updated
07/25/2014
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