Provider Demographics
NPI:1982452868
Name:SANTOS, JENNIFER J
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:J
Last Name:SANTOS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 CLARK WAY STE A
Mailing Address - Street 2:
Mailing Address - City:SOMERSWORTH
Mailing Address - State:NH
Mailing Address - Zip Code:03878-4403
Mailing Address - Country:US
Mailing Address - Phone:603-692-2045
Mailing Address - Fax:
Practice Address - Street 1:8 CLARK WAY STE A
Practice Address - Street 2:
Practice Address - City:SOMERSWORTH
Practice Address - State:NH
Practice Address - Zip Code:03878-4403
Practice Address - Country:US
Practice Address - Phone:603-692-2045
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-07
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH03042124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist