Most Relevant Information
Provider Data
| NPI Number: | 1003212242 |
| Provider Name: | JENNIFER SUE NETTLES R.D.H |
| Entity Type: | Individual |
| Taxonomy Code: | 124Q00000X |
| Specialty: | Dental Hygienist |
| License Number: | 4144 |
Most Important Dates
| Enumeration Date: | 11/17/2014 |
| Last Updated: | 11/17/2014 |
Provider Practice Location
916 KENTUCKY AVE
PADUCAH
KY
420031955
Practice Location Phone/Fax
| Phone: | 2704449625 |
| Fax: | 2705755458 |
Provider Mailing Location
916 KENTUCKY AVE
PADUCAH
KY
420031955
Provider Mailing Phone/Fax
| Phone: | 2704449625 |
| Fax: | 2705755458 |