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Organization
SCOTT JACKS, DDS, INC
Active
Organization
SCOTT JACKS, DDS, INC
Active
Other names
CHILDREN'S DENTAL GROUP
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JERRY DAVID MINSKY D.D.S. (OWNER)
(323) 564-2444
Entity
Organization
Contact information
Practice address
897 E EL CAMINO REAL, SUNNYVALE, CA 94087-2937
(877) 567-6453
(323) 923-1088
Mailing address
4444 TWEEDY BLVD, SOUTH GATE, CA 90280-6304
(323) 564-2444
(323) 923-1088
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
31668
CA
1223P0221X
Pediatric Dentistry
31668
CA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
31668
CA
Other
Enumeration date
03/10/2011
Last updated
09/23/2015
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