Individual
JENNIE M VAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
3804 E COLONIAL DR, ORLANDO, FL 32803-5208
(407) 898-3800
(407) 895-0503
Mailing address
3804 E COLONIAL DR, ORLANDO, FL 32803-5208
(407) 898-3800
(407) 895-0503
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN17997
FL
Other
Enumeration date
07/23/2007
Last updated
04/24/2023
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