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General NPI Number Information
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NPI Number | 1326663816
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Entity Type | Individual
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Provider Name | JENNIFER STOLOW DDS
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Gender | Female
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Dates
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Enumeration Date | 06/10/2020
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Last Update Date | 02/07/2023
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Provider Practice Location Address
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Address Line | 13005 SW 1ST RD STE 233
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City | NEWBERRY
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State | FL
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Zip | 32669-3266
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Country | US
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Telephone | 352-436-4215
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Fax |
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Provider Business Mailing Address
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Address Line | 8534 SW 68TH RD
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City | GAINESVILLE
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State | FL
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Zip | 32608-5696
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Country | US
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Telephone | 954-593-1350
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | 0442000411
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 26808
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License Number State | FL
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