Provider Demographics
NPI:1831106376
Name:COLE, JENNIFER ELIZABETH (DDS)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:ELIZABETH
Last Name:COLE
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 1:175 TEQUESTA DR
Mailing Address - Street 2:SUITE C
Mailing Address - City:TEQUESTA
Mailing Address - State:FL
Mailing Address - Zip Code:33469-2733
Mailing Address - Country:US
Mailing Address - Phone:561-746-7684
Mailing Address - Fax:561-746-1430
Practice Address - Street 1:175 TEQUESTA DR
Practice Address - Street 2:SUITE C
Practice Address - City:TEQUESTA
Practice Address - State:FL
Practice Address - Zip Code:33469-2733
Practice Address - Country:US
Practice Address - Phone:561-746-7684
Practice Address - Fax:561-746-1430
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN00140691223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice