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General NPI Number Information
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NPI Number | 1467766808
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Entity Type | Individual
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Provider Name | JENNIFER E CROMEYER D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 07/27/2010
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Last Update Date | 03/20/2013
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Provider Practice Location Address
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Address Line | 4500 47TH AVE STE 1
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City | SACRAMENTO
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State | CA
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Zip | 95824-3848
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Country | US
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Telephone | 916-422-1917
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Fax | 916-422-2459
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Provider Business Mailing Address
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Address Line | 5050 LAGUNA BLVD STE 112-601
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City | ELK GROVE
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State | CA
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Zip | 95758-4151
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Country | US
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Telephone |
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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 | 59396
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License Number State | CA
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