Provider Demographics
NPI:1235397225
Name:DUNCAN, JENNIFER GAIL (DMD)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:GAIL
Last Name:DUNCAN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1282
Mailing Address - Street 2:
Mailing Address - City:SKIPPACK
Mailing Address - State:PA
Mailing Address - Zip Code:19474-1282
Mailing Address - Country:US
Mailing Address - Phone:215-699-1009
Mailing Address - Fax:215-699-1022
Practice Address - Street 1:298 WISSAHICKON AVENUE
Practice Address - Street 2:SUITE 3
Practice Address - City:NORTH WALES
Practice Address - State:PA
Practice Address - Zip Code:19454
Practice Address - Country:US
Practice Address - Phone:215-699-1009
Practice Address - Fax:215-699-1022
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-28
Last Update Date:2011-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0374571223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice