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NPI Code Detail

MEDICARE: DR. JASON MATTHEW JENNINGS DMD

MEDICARE:  DR. JASON MATTHEW JENNINGS  DMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist3457-08MS

General Provider Information

NPI Number : 1598926081
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JASON MATTHEW JENNINGS DMD
Provider Business Mailing Address
First Line : 716 1ST ST
Second Line :
City : CLEVELAND
State : MS
Zip : 38732-2308
Country : US
Telephone Number : 662-843-2955
Fax Number : 662-843-2956
Provider Business Practice Location Address
First Line : 716 1ST ST
Second Line :
City : CLEVELAND
State : MS
Zip : 38732-2308
Country : US
Telephone Number : 662-843-2955
Fax Number : 662-843-2956
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/18/2008
Last Update Date : 06/18/2008

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Directions to “ DR. JASON MATTHEW JENNINGS DMD” Practice Location

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