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General NPI Number Information
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NPI Number | 1689774341
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Entity Type | Individual
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Provider Name | DENNIS EUGENE JENNINGS DDS
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Gender | Male
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Dates
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Enumeration Date | 09/23/2006
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Last Update Date | 07/23/2007
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Provider Practice Location Address
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Address Line | 5553 WATERFORD LN
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City | APPLETON
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State | WI
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Zip | 54913-8468
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Country | US
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Telephone | 920-739-7165
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Fax | 920-739-7361
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Provider Business Mailing Address
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Address Line | 216 E BENTON DR
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City | APPLETON
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State | WI
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Zip | 54913-8688
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Country | US
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Telephone | 920-734-7487
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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 | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | 5806015
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | 12024
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License Number State | TX
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