Individual
DR. JENNIFER YESSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
430 MAIN ST, GREEN BAY, WI 54301-5115
(902) 431-0345
Mailing address
430 MAIN ST, GREEN BAY, WI 54301-5115
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
1001683-15
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/24/2015
Last updated
09/03/2020
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