Provider Demographics
NPI:1275690893
Name:RUTLEDGE, JENNIFER ANN (DDS)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:ANN
Last Name:RUTLEDGE
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 1:805 MOSS CLIFF CIR
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071-7627
Mailing Address - Country:US
Mailing Address - Phone:214-532-4633
Mailing Address - Fax:
Practice Address - Street 1:5323 W UNIVERSITY DR
Practice Address - Street 2:SUITE 100
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75071-7824
Practice Address - Country:US
Practice Address - Phone:214-436-5555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2015-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX227331223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry