Individual
JENNA HERR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1352 SOUTH ST # C3, PHILADELPHIA, PA 19147-1858
(149) 521-5800
Mailing address
322 S 15TH ST APT 3F, PHILADELPHIA, PA 19102-4910
(518) 944-4481
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
22DI03052000
NJ
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DS043238
PA
Other
Enumeration date
05/05/2025
Last updated
05/05/2025
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