Individual
MRS. JENIFER JO MODEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
3434 E WASHINGTON AVE, MADISON, WI 53704-4155
(608) 443-5550
(608) 443-5554
Mailing address
2901 W BELTLINE HWY, STE. 120, MADISON, WI 53713-4226
(608) 443-5500
(608) 441-2385
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
5591-016
WI
Other
Enumeration date
08/29/2011
Last updated
08/29/2011
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