Individual
DR. JENNIFER LOIS FRASER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
35 CAROLINE STREET, BUNNELL, FL 32110
(386) 672-7710
(386) 313-1970
Mailing address
35 CAROLINE ST, BUNNELL, FL 32110-8902
(386) 672-7710
(386) 313-1970
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN19401
FL
Other
Enumeration date
03/26/2007
Last updated
01/09/2013
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