Provider Demographics
NPI:1366596090
Name:MANSKE, JENNIFER LYNN (DDS)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:LYNN
Last Name:MANSKE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:14062 DENVER WEST PKWY
Mailing Address - Street 2:BUILDING 52, SUITE 145
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80401-3187
Mailing Address - Country:US
Mailing Address - Phone:303-277-9024
Mailing Address - Fax:303-278-2418
Practice Address - Street 1:14062 DENVER WEST PKWY
Practice Address - Street 2:BUILDING 52, SUITE 145
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80401-3187
Practice Address - Country:US
Practice Address - Phone:303-277-9024
Practice Address - Fax:303-278-2418
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO86631223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice