Provider Demographics
NPI:1487076741
Name:DAY, JENNIFER M (DMD)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:M
Last Name:DAY
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1410 NW 13TH ST STE 8
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32601-4085
Mailing Address - Country:US
Mailing Address - Phone:352-376-8207
Mailing Address - Fax:352-375-1802
Practice Address - Street 1:1410 NW 13TH ST STE 8
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32601-4085
Practice Address - Country:US
Practice Address - Phone:352-376-8207
Practice Address - Fax:352-375-1802
Is Sole Proprietor?:No
Enumeration Date:2014-01-06
Last Update Date:2014-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL175371223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice