Individual
DR. JENNA R SCHULTEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
1001 N DUPONT SQ, LOUISVILLE, KY 40207-4612
(270) 789-7890
Mailing address
1103 DELOR AVE, LOUISVILLE, KY 40217-2226
(270) 789-7890
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
8868
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100151020
—
KY
Enumeration date
05/26/2010
Last updated
09/03/2014
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