Individual
DR. JODI KAY HENTSCHER-JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
200 E MILL ST, WATERLOO, IL 62298-1519
(618) 939-2900
Mailing address
200 E MILL ST, WATERLOO, IL 62298-1519
(618) 939-2900
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
019.028038
IL
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
2009016934
MO
Other
Enumeration date
11/30/2011
Last updated
11/30/2011
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