Provider Demographics
NPI:1306022405
Name:KWIATKOWSKI, JENNI (DDS)
Entity Type:Individual
Prefix:DR
First Name:JENNI
Middle Name:
Last Name:KWIATKOWSKI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 INWOOD RD
Mailing Address - Street 2:
Mailing Address - City:LINDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07036-5329
Mailing Address - Country:US
Mailing Address - Phone:908-303-4911
Mailing Address - Fax:
Practice Address - Street 1:701 INWOOD RD
Practice Address - Street 2:
Practice Address - City:LINDEN
Practice Address - State:NJ
Practice Address - Zip Code:07036-5329
Practice Address - Country:US
Practice Address - Phone:908-303-4911
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-18
Last Update Date:2008-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI02368300122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist