MEDICARE: DR. JENNA KATZ SCHWIBNER D.M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	DN19361	FL

General Provider Information

NPI Number	:	1043507874
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JENNA KATZ SCHWIBNER D.M.D.

Provider Business Mailing Address
First Line	:	1225 NEAR OCEAN DR
Second Line	:
City	:	VERO BEACH
State	:	FL
Zip	:	32963-2392
Country	:	US
Telephone Number	:	772-559-1453
Fax Number	:

Provider Business Practice Location Address
First Line	:	1225 NEAR OCEAN DR
Second Line	:
City	:	VERO BEACH
State	:	FL
Zip	:	32963-2392
Country	:	US
Telephone Number	:	772-559-1453
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/30/2011
Last Update Date	:	06/30/2011

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