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Organization
JACK D. KING, DDS, PA
Active
Organization
JACK D. KING, DDS, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACK DOUGLAS KING DDS (PRESIDENT)
(704) 873-1968
Entity
Organization
Contact information
Practice address
1706 DAVIE AVE, SUITE B, STATESVILLE, NC 28677-3589
(704) 873-1968
(704) 872-5841
Mailing address
1706 DAVIE AVE, SUITE B, STATESVILLE, NC 28677-3589
(704) 873-1968
(704) 872-5841
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
5157
NC
Other
Enumeration date
02/16/2012
Last updated
02/16/2012
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