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Individual

MRS. LISA RENEE JENNINGS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RDH

Contact information

Practice address
3410 INDIAN SCHOOL RD NE, ALBUQUERQUE, NM 87106-1148
(505) 265-6921
(505) 268-5918
Mailing address
3410 INDIAN SCHOOL RD NE, ALBUQUERQUE, NM 87106-1148
(505) 265-6921
(505) 268-5918

Taxonomy

Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
DH3594
NM

Other

Enumeration date
10/23/2012
Last updated
10/23/2012
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