Individual
DR. MARITZA O JENKINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
3823 E MORGAN AVE, EVANSVILLE, IN 47715-2241
(812) 474-1020
Mailing address
3823 E MORGAN AVE, EVANSVILLE, IN 47715-2241
(812) 474-1020
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12009822
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200089640A
—
IN
Enumeration date
10/10/2006
Last updated
02/09/2015
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