Individual
DR. JENNIFER L FULL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
BOAK DENTAL CLINIC, 12720 KANSAS AVE BLDG 789, FORT LEONARD WOOD, MO 65473-6547
(706) 718-4719
Mailing address
US ARMY DENTAL ACTIVITY, 6958 NEBRASKA AVE BUILDING 1608, FORT LEONARD WOOD, MO 65473
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DDS-09585
IA
Other
Enumeration date
08/07/2018
Last updated
03/18/2021
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