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Organization
NORTH JACKSON DENTAL GROUP
Active
Organization
NORTH JACKSON DENTAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HUE MY TO DDS (VICE PRESIDENT OF THE CORPORATION)
(408) 923-8272
Entity
Organization
Contact information
Practice address
125 N JACKSON AVE, SUITE #104, SAN JOSE, CA 95116
(408) 923-8272
(408) 923-8211
Mailing address
125 N JACKSON AVE, SUITE #104, SAN JOSE, CA 95116
(408) 923-8272
(408) 923-8211
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
23951
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
G9089201
—
CA
Enumeration date
07/30/2006
Last updated
08/22/2020
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