Provider Demographics
NPI:1053752030
Name:FORESTIER, JESSICA ANN (DDS)
Entity type:Individual
Prefix:MISS
First Name:JESSICA
Middle Name:ANN
Last Name:FORESTIER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7780 BRIER CREEK PKWY STE 120
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27617-7850
Mailing Address - Country:US
Mailing Address - Phone:919-957-4500
Mailing Address - Fax:919-957-4577
Practice Address - Street 1:7780 BRIER CREEK PKWY STE 120
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27617-7850
Practice Address - Country:US
Practice Address - Phone:919-957-4500
Practice Address - Fax:919-957-4577
Is Sole Proprietor?:No
Enumeration Date:2013-07-08
Last Update Date:2013-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9519122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist