Provider Demographics
NPI:1942497904
Name:KINTZ-SMITH, JENNIFER (HYGENIST)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:KINTZ-SMITH
Suffix:
Gender:F
Credentials:HYGENIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:ELMIRA
Mailing Address - State:NY
Mailing Address - Zip Code:14901-3220
Mailing Address - Country:US
Mailing Address - Phone:607-737-2028
Mailing Address - Fax:
Practice Address - Street 1:103 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:ELMIRA
Practice Address - State:NY
Practice Address - Zip Code:14901-3220
Practice Address - Country:US
Practice Address - Phone:607-737-2028
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-03
Last Update Date:2007-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022854-1124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist