Individual
MS. JENNIFER ROSE FASOLINO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
EFDA
Contact information
Practice address
6037 BESSINGER ST, FORT SILL, OK 73503-4406
(580) 442-5544
Mailing address
6037 BESSINGER ST, FORT SILL, OK 73503-4406
(580) 442-5544
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
—
—
Other
Enumeration date
06/14/2016
Last updated
03/04/2022
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