Individual
JENNIFER L CAVANAUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
1111 N PARKWAY FRONTAGE RD, LAKELAND, FL 33803-0400
(863) 644-2408
Mailing address
3032 VIA RIALTO ST, FORT MYERS, FL 33905-5412
(412) 370-3634
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DS038741
PA
1223P0221X
Pediatric Dentistry
Primary
DN19962
FL
Other
Enumeration date
07/03/2011
Last updated
01/02/2020
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