Individual
JACQUELINE MARIE FETNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
1395 CENTER DR # D1-17, GAINESVILLE, FL 32610-1201
(352) 273-7643
Mailing address
1470 AVONDALE AVE, JACKSONVILLE, FL 32205-7823
(941) 726-2666
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN21960
FL
Other
Enumeration date
05/04/2016
Last updated
07/01/2020
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