Individual
MS. JENNA SUSANNE GAUGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ADT
Contact information
Practice address
2100 11TH ST E, GLENCOE, MN 55336-2625
(320) 864-3129
(320) 269-6408
Mailing address
209 SOUTH 1ST STREET, MONTEVIDEO, MN 56265
(320) 269-6406
(320) 269-6408
Taxonomy
Speciality
Code
Description
License number
State
125J00000X
Dental Therapist
Primary
DT55
MN
Other
Enumeration date
05/01/2015
Last updated
02/23/2022
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