Individual
DR. JENNIFER VAUGHN LYSENKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
1604 GRAVES MILL RD, LYNCHBURG, VA 24502-5174
(434) 385-7307
Mailing address
1064 GRAVES MILL RD, LYNCHBURG, VA 24502
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401414414
VA
Other
Enumeration date
08/24/2013
Last updated
08/08/2014
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