| Provider / Organization | NPI | Date Certified |
|---|---|---|
| JENNA MAE FONGEMIE | 1235860545 | 2022-06-19 |
Jenna Mae Fongemie is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1235860545. Registration indicates Jenna Mae Fongemie is a provider of access to dentists-general services with a specialization in Dental Providers, Dentist (Dental Providers, Dentist) (Dentist: General Practice, ) (Dental, ) (Dentist General Practice, Dental Providers) (Dentist, )
| Entity Type | Individual |
| Provider Name | Dr. Jenna Mae Fongemie DMD |
| Practice Office Address | 94 WESTERN AVE STE 1 AUGUSTA, ME US |
| Practice Office Telephone | 2076221488 |
| Mailing Address | 94 WESTERN AVE STE 1 AUGUSTA, ME 043307269 US |
| Business Telephone | 2076221488 |
| Code | Practice | License No State |
|---|---|---|
| 1223G0001X PRIMARY | Access to Dentists-General Dental Providers Dentist Dental Providers Dentist Dentist: General Practice Dental Dentist General Practice Dental Providers Dentist | DEN4978
ME |