Individual
JENNA BLAIR DEBBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
111 E 57TH ST RM 204, NEW YORK, NY 10022-2645
(917) 858-7155
Mailing address
111 E 57TH ST RM 204, NEW YORK, NY 10022-2645
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
062655
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/03/2021
Last updated
11/14/2022
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