Provider Demographics
NPI:1003315094
Name:DENNO, JODELL (RDH)
Entity Type:Individual
Prefix:
First Name:JODELL
Middle Name:
Last Name:DENNO
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:JODELL
Other - Middle Name:
Other - Last Name:COBB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDH
Mailing Address - Street 1:G3222 BEECHER RD
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532-3614
Mailing Address - Country:US
Mailing Address - Phone:810-732-0200
Mailing Address - Fax:810-732-4355
Practice Address - Street 1:G3222 BEECHER RD
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-3614
Practice Address - Country:US
Practice Address - Phone:810-732-0200
Practice Address - Fax:810-732-4355
Is Sole Proprietor?:No
Enumeration Date:2018-02-06
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist