Provider Demographics
NPI:1477858876
Name:ENLOW, JENNIFER DAVIS (DDS)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:DAVIS
Last Name:ENLOW
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 1:7132 ELK MAR DR
Mailing Address - Street 2:
Mailing Address - City:ELKRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21075-1097
Mailing Address - Country:US
Mailing Address - Phone:410-379-3092
Mailing Address - Fax:
Practice Address - Street 1:5126 DORSEY HALL DR
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042-7887
Practice Address - Country:US
Practice Address - Phone:410-740-9400
Practice Address - Fax:410-740-2105
Is Sole Proprietor?:No
Enumeration Date:2011-01-14
Last Update Date:2011-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD132581223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice