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General NPI Number Information
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NPI Number | 1043536113
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Entity Type | Individual
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Provider Name | CECILE JENTNER M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/14/2010
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Last Update Date | 11/07/2013
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Provider Practice Location Address
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Address Line | 50 N MILLER RD
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City | FAIRLAWN
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State | OH
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Zip | 44333-3702
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Country | US
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Telephone | 330-836-9721
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Fax | 330-836-9627
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Provider Business Mailing Address
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Address Line | 50 N MILLER RD
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City | FAIRLAWN
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State | OH
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Zip | 44333-3702
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Country | US
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Telephone | 330-836-9721
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Fax | 330-836-9627
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 35121123
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License Number State | OH
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