Individual
JASON JENNY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
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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