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General NPI Number Information
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NPI Number | 1396557476
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Entity Type | Organization
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Legal Business Name | JENNA GODWIN LLC
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Dates
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Enumeration Date | 01/24/2025
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Last Update Date | 01/24/2025
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Provider Practice Location Address
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Address Line | 8277 113TH ST
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City | SEMINOLE
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State | FL
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Zip | 33772-4128
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Country | US
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Telephone | 727-397-8500
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Fax | 727-393-2977
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Provider Business Mailing Address
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Address Line | PO BOX 25008
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City | OKLAHOMA CITY
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State | OK
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Zip | 73125-0008
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Country | US
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Telephone | 727-297-8500
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Fax | 727-393-2977
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Authorized Official
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Title or Position | OWNER
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Name | DR. JENNA GODWIN
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Credential | DDS
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Telephone | 727-297-8500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number |
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License Number State |
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