Individual
JENNIFER CORONADO LOSIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
720 E COLISEUM BLVD, FORT WAYNE, IN 46805-1220
(260) 483-4000
(260) 444-4316
Mailing address
4170 GRAPE ROAD, MISHAWAKA, IN 46545
(574) 272-4200
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12011808A
IN
Other
Enumeration date
06/11/2012
Last updated
09/02/2021
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