| Kenneth J. Jackson D.d.s., Inc. | |
|
809 Redskin Trl Wapakoneta OH 45895-8546 | |
| (419) 738-2426 | |
| Not Available |
| Full Name | Kenneth J. Jackson D.d.s., Inc. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 809 Redskin Trl, Wapakoneta, Ohio |
| Authorized Official Name and Position | Kenneth J Jackson (PRESIDENT) |
| Authorized Official Contact | 4197382426 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kenneth J. Jackson D.d.s., Inc. 809 Redskin Trl Wapakoneta OH 45895-8546 Ph: (419) 738-2426 | Kenneth J. Jackson D.d.s., Inc. 809 Redskin Trl Wapakoneta OH 45895-8546 Ph: (419) 738-2426 |
| NPI Number | 1902070998 |
|---|---|
| Provider Enumeration Date | 04/22/2008 |
| Last Update Date | 04/22/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902070998 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 20856 (Ohio) | Primary |
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