Provider Demographics
NPI:1588015382
Name:DOBZANSKI, JENNIFER (DMD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:
Last Name:DOBZANSKI
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 1:2001 HAMILTON ST APT 2214
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19130-4209
Mailing Address - Country:US
Mailing Address - Phone:215-262-2856
Mailing Address - Fax:
Practice Address - Street 1:2929 KLOCKNER RD
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08690-2809
Practice Address - Country:US
Practice Address - Phone:609-586-6603
Practice Address - Fax:609-528-3003
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-23
Last Update Date:2021-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI026964001223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty