Individual
MARY SUSAN JENNINGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1921 STONECIPHER DR, ADA, OK 74820-3439
(580) 436-3980
Mailing address
1921 STONECIPHER DR, ADA, OK 74820-3439
(580) 436-3980
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4995
OK
1223G0001X
General Practice Dentistry
DE00007586
WA
Other
Enumeration date
08/26/2005
Last updated
03/08/2019
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