Jennifer M Williams Driver, DMD
Dentist, General Practice in Roseburg, OR. Individual provider (NPI-1).
NPI number1144452004
StatusActive
Last updated in NPPESJun 10, 2011
Details
- NPI
- 1144452004
- Entity type
- Individual (NPI-1)
- Name
- Jennifer M Williams Driver
- Credential
- DMD
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Aug 11, 2009
- Last updated
- Jun 10, 2011
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | D9453 | OR | Yes |
| 122300000X | Dentist | D4251 | ID |
Practice location
1651 Nw Hughwood CtRoseburg, OR 97471-8834
Phone 541-672-8187 · Fax 541-672-0224
Mailing address
299 Hidden Valley LnRoseburg, OR 97471-8255
Phone 208-866-6907
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