Individual
TENNILLE H. PENN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
75 SHERRY AVE, PARK FALLS, WI 54552-1468
(715) 762-0200
Mailing address
1000 N OAK AVE, MARSHFIELD, WI 54449-5703
(715) 387-5511
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
D0962
SD
1223G0001X
General Practice Dentistry
Primary
6998
WI
Other
Enumeration date
06/17/2009
Last updated
06/28/2013
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