Individual
JASON ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
105 BROADMOOR DR, MADISON, MS 39110-6651
(601) 856-5227
Mailing address
200 BORDEAUX DR, CLINTON, MS 39056-5749
(901) 277-0260
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4368-23
MS
Other
Enumeration date
06/02/2023
Last updated
06/02/2023
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