| Jackson Dental, Llc | |
|
3100 E Jackson Blvd Jackson MO 63755-2957 | |
| (573) 243-5200 | |
| Not Available |
| Full Name | Jackson Dental, Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 3100 E Jackson Blvd, Jackson, Missouri |
| Authorized Official Name and Position | Kay Lynn Welker (OFFICE ADMINISTRATOR) |
| Authorized Official Contact | 5732435200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jackson Dental, Llc 3100 E Jackson Blvd Jackson MO 63755-2957 Ph: (573) 243-5200 | Jackson Dental, Llc 3100 E Jackson Blvd Jackson MO 63755-2957 Ph: (573) 243-5200 |
| NPI Number | 1932260338 |
|---|---|
| Provider Enumeration Date | 12/12/2006 |
| Last Update Date | 05/18/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932260338 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 013049 (Missouri) | Primary |
Jackson Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 3100 E Jackson Blvd, Jackson, MO 63755 Phone: 573-243-5200 Fax: 573-243-7571 |