Provider Demographics
NPI:1043507874
Name:SCHWIBNER, JENNA KATZ (DMD)
Entity Type:Individual
Prefix:DR
First Name:JENNA
Middle Name:KATZ
Last Name:SCHWIBNER
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:JENNA
Other - Middle Name:DANIELLE
Other - Last Name:KATZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1225 NEAR OCEAN DR
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32963-2392
Mailing Address - Country:US
Mailing Address - Phone:772-559-1453
Mailing Address - Fax:
Practice Address - Street 1:1225 NEAR OCEAN DR
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32963-2392
Practice Address - Country:US
Practice Address - Phone:772-559-1453
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-30
Last Update Date:2011-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN193611223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice