Provider Demographics
NPI:1346619657
Name:DROSSNER, JENNIFER (DDS)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:
Last Name:DROSSNER
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 1:230 TARAWA ST
Mailing Address - Street 2:
Mailing Address - City:BEAUFORT
Mailing Address - State:SC
Mailing Address - Zip Code:29902-7500
Mailing Address - Country:US
Mailing Address - Phone:443-465-5693
Mailing Address - Fax:
Practice Address - Street 1:1274 RIBAUT RD
Practice Address - Street 2:
Practice Address - City:BEAUFORT
Practice Address - State:SC
Practice Address - Zip Code:29902-6187
Practice Address - Country:US
Practice Address - Phone:843-524-6363
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-16
Last Update Date:2022-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901600121122300000X
SC103201223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist