Individual
SAMANTHA JETTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
103 STEELE ST, BRIDGEPORT, WV 26330-1068
(304) 282-1640
Mailing address
63 KINGSTON DR, BRIDGEPORT, WV 26330-1587
(304) 282-1640
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4186
WV
Other
Enumeration date
09/03/2015
Last updated
02/20/2021
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