| NPI | 1770922940 |
|---|---|
| Former Name | JENNA LAUREN BEHRENTS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MO 2017004356) |
| Additional Taxonomies | 122300000X Dentist (Licence: KS 61944) |
| 1223G0001X Dentist, General Practice (Licence: AZ D008754) | |
| Enumeration Date | 2013-06-20 |
| Last Update Date | 2021-09-24 |