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Individual

DENNIS EUGENE JENNINGS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
5553 WATERFORD LN, APPLETON, WI 54913-8468
(920) 739-7165
(920) 739-7361
Mailing address
216 E BENTON DR, APPLETON, WI 54913-8688
(920) 734-7487

Taxonomy

Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
12024
TX
1223P0700X
Prosthodontics
Primary
5806015
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
33792400
WI
Enumeration date
09/23/2006
Last updated
07/23/2007
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