| Jae Dental Pllc | |
|
201 S Rogers Rd Irving TX 75060-2608 | |
| (817) 710-7443 | |
| (817) 710-1447 |
| Full Name | Jae Dental Pllc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 201 S Rogers Rd, Irving, Texas |
| Authorized Official Name and Position | Jason Troy Bacon (OWNER) |
| Authorized Official Contact | 8177107443 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jae Dental Pllc 6726 Camp Bowie Blvd Fort Worth TX 76116-7113 Ph: (817) 710-7443 | Jae Dental Pllc 201 S Rogers Rd Irving TX 75060-2608 Ph: (817) 710-7443 |
| NPI Number | 1265987598 |
|---|---|
| Provider Enumeration Date | 08/16/2016 |
| Last Update Date | 08/16/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265987598 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 24381 (Texas) | Primary |
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