MEDICARE: DR. JENNIFER JOY GRIFFIN D.D.S.

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
1	1223G0001X	General Practice Dentistry	5417	OK

General Provider Information

NPI Number	:	1821090382
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JENNIFER JOY GRIFFIN D.D.S.

Provider Business Mailing Address
First Line	:	2820 NW 32ND ST
Second Line	:
City	:	NEWCASTLE
State	:	OK
Zip	:	73065-6576
Country	:	US
Telephone Number	:	405-392-4883
Fax Number	:	405-392-4883

Provider Business Practice Location Address
First Line	:	2820 NW 32ND ST
Second Line	:
City	:	NEWCASTLE
State	:	OK
Zip	:	73065-6576
Country	:	US
Telephone Number	:	405-392-4883
Fax Number	:	405-392-4883

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/15/2005
Last Update Date	:	07/08/2007

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Directions to “ DR. JENNIFER JOY GRIFFIN D.D.S.” Practice Location

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