Centerille Pediatric Dentistry, Kyle R Jackson, Dds, Inc | |
273 Regency Ridge Dr Centerville OH 45459-4221 | |
(937) 586-7729 | |
(937) 660-4450 |
Full Name | Centerille Pediatric Dentistry, Kyle R Jackson, Dds, Inc |
---|---|
Speciality | Dentist - Pediatric Dentistry |
Location | 273 Regency Ridge Dr, Centerville, Ohio |
Authorized Official Name and Position | Kyle R. Jackson (DENTIST/OWNER) |
Authorized Official Contact | 9375867729 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Centerille Pediatric Dentistry, Kyle R Jackson, Dds, Inc 273 Regency Ridge Dr Centerville OH 45459-4221 Ph: (937) 586-7729 | Centerille Pediatric Dentistry, Kyle R Jackson, Dds, Inc 273 Regency Ridge Dr Centerville OH 45459-4221 Ph: (937) 586-7729 |
NPI Number | 1386073112 |
---|---|
Provider Enumeration Date | 11/02/2013 |
Last Update Date | 08/11/2016 |
Identifier | Type | State | Issuer |
---|---|---|---|
1386073112 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223P0221X | Dentist - Pediatric Dentistry | 30018976 (Ohio) | Primary |
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