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Organization
BALANCED DENTAL
Active
Organization
BALANCED DENTAL
Active
Parent organization
DAVID C JACKSON DMD PA
Other names
Balanced Dental
Organization subpart
Yes
Provider details
NPI number
Legal business name
DAVID C JACKSON DMD PA
Authorized official
DR. DAVID CRESTON JACKSON DMD (PRESIDENT)
(772) 247-2407
Entity
Organization
Contact information
Practice address
900 SE OCEAN BLVD STE 110B, STUART, FL 34994-3503
(954) 818-6102
Mailing address
900 SE OCEAN BLVD STE 110B, STUART, FL 34994-3503
(772) 247-2407
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
07/18/2017
Last updated
10/08/2017
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