Individual
JENNIFER LYNN FAWAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
4102 PINION DR, 10TH MEDICAL GROUP-SGDD, USAF ACADEMY, CO 80840-2502
(719) 333-5191
Mailing address
4102 PINION DR, 10TH MEDICAL GROUP-SGDD, USAF ACADEMY, CO 80840-2502
(719) 333-5191
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
904354
CO
Other
Enumeration date
11/01/2007
Last updated
11/01/2007
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