Organization
JASON K POTTER MD DDS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JASON K POTTER M.D., D.D.S. (OWNER)
(214) 930-6588
Entity
Organization
Contact information
Practice address
8220 WALNUT HILL LN, SUITE 206, DALLAS, TX 75231-4427
(214) 930-6588
Mailing address
PO BOX 93982, SOUTHLAKE, TX 76092-0119
(214) 930-6588
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
M6345
TX
Other
Enumeration date
01/14/2008
Last updated
10/22/2008
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