Individual
JESSICA HENNIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
880 HERRIOT DR, MAUSTON, WI 53948-2031
(608) 847-6700
(608) 847-6122
Mailing address
FAMILY HEALTH LA CLINICA, 400 S. TOWNLINE RD., WAUTOMA, WI 54982
(920) 787-5514
(920) 787-4737
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
1003469
WI
Other
Enumeration date
07/13/2022
Last updated
07/13/2022
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