Individual
JENNIE ISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3200 S UNIVERSITY DR, DAVIE, FL 33328-2018
(954) 262-1761
Mailing address
1010 MAIN ST S, MC KEE, KY 40447-7089
(606) 287-7104
(606) 287-4409
Taxonomy
Speciality
Code
Description
License number
State
1223P0106X
Oral and Maxillofacial Pathology Dentistry
Primary
9196
KY
Other
Enumeration date
09/26/2012
Last updated
12/22/2021
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