Individual
JENNIFER CANADA MCKNIGHT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
3387 HIGHWAY 5, DOUGLASVILLE, GA 30135-6900
(678) 813-2388
Mailing address
6725 N. 35TH AVE., #105, PHOENIX, AZ 85017
(602) 595-5230
(602) 595-5280
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
9796
AZ
1223P0221X
Pediatric Dentistry
Primary
DN123035
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/08/2015
Last updated
11/01/2023
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