Individual
JACKIE JANZEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1569 JANMAR RD STE A, SNELLVILLE, GA 30078-5780
(770) 979-7923
Mailing address
255 GATEWAY DR STE 200, BETHLEHEM, GA 30620-1823
(678) 963-5790
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN016095
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/20/2020
Last updated
06/20/2024
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