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Individual

DR. JASON C LACOURSE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
2441 21ST ST, FORT CAMPBELL, KY 42223-5582
(270) 412-6027
Mailing address
2441 21ST ST, FORT CAMPBELL, KY 42223-5582
(270) 412-6027

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7735000-9921
UT

Other

Enumeration date
10/10/2011
Last updated
05/28/2025
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