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General NPI Number Information
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NPI Number | 1386532646
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Entity Type | Individual
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Provider Name | JESSICA BOOMHOWER DMD
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Gender | Female
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Dates
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Enumeration Date | 06/25/2025
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Last Update Date | 06/25/2025
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Provider Practice Location Address
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Address Line | 14013 N CREEK VILLAGE DR STE 100
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City | HUNTERSVILLE
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State | NC
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Zip | 28078-4018
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Country | US
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Telephone | 980-306-2150
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Fax |
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Provider Business Mailing Address
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Address Line | 9921 HOLLY CENTER DR APT 2
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City | HUNTERSVILLE
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State | NC
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Zip | 28078-5120
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Country | US
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Telephone | 407-446-8499
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 14287
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License Number State | NC
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