Provider Demographics
NPI:1699085480
Name:MCNETT, JADA LYNN
Entity type:Individual
Prefix:
First Name:JADA
Middle Name:LYNN
Last Name:MCNETT
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 1:401 OAK ST
Mailing Address - Street 2:
Mailing Address - City:ARGYLE
Mailing Address - State:WI
Mailing Address - Zip Code:53504-9753
Mailing Address - Country:US
Mailing Address - Phone:608-574-2989
Mailing Address - Fax:
Practice Address - Street 1:435 MAIN ST
Practice Address - Street 2:
Practice Address - City:DARLINGTON
Practice Address - State:WI
Practice Address - Zip Code:53530-1427
Practice Address - Country:US
Practice Address - Phone:608-776-2820
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-14
Last Update Date:2010-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI10070-016124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist