Individual
DR. JENNIFER MANE MATOUSEK-RONCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
614 E EMMA AVE, SUITE 300, SPRINGDALE, AR 72764-4634
(479) 751-7417
(479) 751-4898
Mailing address
614 E EMMA AVE, SUITE 300, SPRINGDALE, AR 72764-4634
(479) 751-7417
(479) 751-4898
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
3815
AR
122300000X
Dentist
5876
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
198665608
—
AR
05
—
200086130A
—
OK
Enumeration date
11/28/2006
Last updated
01/22/2015
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