Individual
JENNIFER FOUNTAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
150 E 58TH ST, 8TH FLOOR ANNEX, NEW YORK, NY 10155-0002
(212) 355-1003
(212) 355-1067
Mailing address
150 E 58TH ST, 8TH FLOOR ANNEX, NEW YORK, NY 10155-0002
(212) 355-1003
(212) 355-1067
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
056073
NY
Other
Enumeration date
06/15/2010
Last updated
03/02/2014
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