Individual
JENNIFER MACEJKOVIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH, BS
Contact information
Practice address
5 S WASHINGTON AVE, JERMYN, PA 18433-1121
(570) 383-9934
(570) 230-0023
Mailing address
111 N WASHINGTON AVE, SCRANTON, PA 18503-1828
(570) 343-2383
(570) 343-3923
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
PHDH000975
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DH073107
LICENSE
PA
Enumeration date
01/29/2018
Last updated
01/29/2018
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