Individual
JENNA EHLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1814 14TH AVE NE, WATERTOWN, SD 57201
(605) 882-0747
Mailing address
378 S LAKE DR, WATERTOWN, SD 57201-5432
(701) 290-1976
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D1438
SD
Other
Enumeration date
06/11/2024
Last updated
06/11/2024
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