Provider Demographics
NPI:1679736003
Name:TASCHNER, JENNIFER F (DDS, MMSC)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:F
Last Name:TASCHNER
Suffix:
Gender:F
Credentials:DDS, MMSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1645 MEDICAL LN
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-1110
Mailing Address - Country:US
Mailing Address - Phone:239-936-0635
Mailing Address - Fax:239-936-0527
Practice Address - Street 1:1645 MEDICAL LN
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907-1110
Practice Address - Country:US
Practice Address - Phone:239-936-0635
Practice Address - Fax:239-936-0527
Is Sole Proprietor?:No
Enumeration Date:2008-07-07
Last Update Date:2009-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN158791223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics