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Individual
JENCEN ROBEY
Active
Individual
JENCEN ROBEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
61464666
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
61464666
DENTAL LICENSE
WA
Enumeration date
08/25/2023
Last updated
08/25/2023
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