Individual
DR. JENNIFER ANNE BROOKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S
Contact information
Practice address
3060 MOBILE HWY, MONTGOMERY, AL 36108-4027
(334) 420-5038
Mailing address
1462 CAMPUS DRIVE, BERKELEY, CA 94708-0365
(209) 658-2982
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5730 C1
AL
1223G0001X
General Practice Dentistry
DN014016
GA
1223P0221X
Pediatric Dentistry
101600
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1275862997
—
AL
Enumeration date
12/08/2009
Last updated
09/07/2017
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