| Steven C. Jacks, D.d.s., Inc. | |
|
7111 N Main St Dayton OH 45415-2565 | |
| (937) 277-8959 | |
| (937) 277-6161 |
| Full Name | Steven C. Jacks, D.d.s., Inc. |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 7111 N Main St, Dayton, Ohio |
| Authorized Official Name and Position | Steven C. Jacks (PRESIDENT) |
| Authorized Official Contact | 9372778959 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Steven C. Jacks, D.d.s., Inc. 7111 N Main St Dayton OH 45415-2565 Ph: (937) 277-8959 | Steven C. Jacks, D.d.s., Inc. 7111 N Main St Dayton OH 45415-2565 Ph: (937) 277-8959 |
| NPI Number | 1295928844 |
|---|---|
| Provider Enumeration Date | 08/27/2007 |
| Last Update Date | 06/13/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295928844 | NPI | - | NPPES |
| 2005092 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 19745 (Ohio) | Primary |
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