Individual
JASON JENNY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
8480 WOODBURY XING STE 120, WOODBURY, MN 55125-9406
(651) 358-7025
(517) 391-4716
Mailing address
8480 WOODBURY XING STE 120, WOODBURY, MN 55125-9406
(651) 358-7025
(517) 391-4716
Taxonomy
Speciality
Code
Description
License number
State
1223P0106X
Oral and Maxillofacial Pathology Dentistry
DD11186
MN
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
D11186
MN
Other
Enumeration date
10/14/2005
Last updated
05/05/2023
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