Individual
MS. JENNIFER A NEISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
3132 W. STATE ROAD 38, PENDLETON, IN 46064
(765) 778-7585
(765) 778-0795
Mailing address
3132 W. STATE ROAD 38, PENDLETON, IN 46064
(765) 778-7585
(765) 778-0795
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
12010223A
IN
1223G0001X
General Practice Dentistry
Primary
D12010223A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200525580
—
IN
Enumeration date
09/07/2006
Last updated
05/07/2013
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