Provider Demographics
NPI:1427223411
Name:SCHNETTLER, JENIFER M (DDS, MSD)
Entity Type:Individual
Prefix:DR
First Name:JENIFER
Middle Name:M
Last Name:SCHNETTLER
Suffix:
Gender:F
Credentials:DDS, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4425 FULTON DR NW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44718-2863
Mailing Address - Country:US
Mailing Address - Phone:330-492-5566
Mailing Address - Fax:330-493-9936
Practice Address - Street 1:4425 FULTON DR NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44718-2863
Practice Address - Country:US
Practice Address - Phone:330-492-5566
Practice Address - Fax:330-493-9936
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-29
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH192911223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics