| Dr Brandon Jackson Pediatric Dental Pllc | |
|
821 Clove Rd Staten Island NY 10310-2839 | |
| (718) 448-0976 | |
| Not Available |
| Full Name | Dr Brandon Jackson Pediatric Dental Pllc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 821 Clove Rd, Staten Island, New York |
| Authorized Official Name and Position | Brandon Joshua Jackson (OWNER) |
| Authorized Official Contact | 9176263507 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Brandon Jackson Pediatric Dental Pllc 70 Virginia Ave Staten Island NY 10305-1748 Ph: (917) 626-3507 | Dr Brandon Jackson Pediatric Dental Pllc 821 Clove Rd Staten Island NY 10310-2839 Ph: (718) 448-0976 |
| NPI Number | 1629789722 |
|---|---|
| Provider Enumeration Date | 12/09/2022 |
| Last Update Date | 12/09/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629789722 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
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