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General NPI Number Information
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NPI Number | 1083276174
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Entity Type | Individual
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Provider Name | JENNIE ANN BARBER RDH
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Gender | Female
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Dates
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Enumeration Date | 06/28/2019
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Last Update Date | 06/28/2019
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Provider Practice Location Address
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Address Line | 605 W LUMSDEN RD
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City | BRANDON
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State | FL
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Zip | 33511-5911
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Country | US
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Telephone | 855-939-2667
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Fax | 855-939-2668
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Provider Business Mailing Address
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Address Line | 10830 JOHANNA AVE
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City | RIVERVIEW
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State | FL
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Zip | 33578-4402
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Country | US
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Telephone | 813-734-3342
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Fax |
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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 | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | DH18429
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License Number State | FL
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