Individual
DR. JOSHUA JACKSTIEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
8301 E PRENTICE AVE STE 215, GREENWOOD VILLAGE, CO 80111-2990
(720) 606-4220
(720) 606-4221
Mailing address
8301 E PRENTICE AVE STE 215, GREENWOOD VILLAGE, CO 80111-2990
(720) 606-4220
(720) 606-4221
Taxonomy
Speciality
Code
Description
License number
State
1223D0004X
Dental Anesthesiology
Primary
00201856
CO
1223D0004X
Dental Anesthesiology
8590166-9924
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
13430734
—
CO
Enumeration date
04/20/2012
Last updated
07/21/2022
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