Organization
JACKSON DENTAL GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KYLE JACKSON DDS (PRESIDENT)
(937) 689-2717
Entity
Organization
Contact information
Practice address
7908 CINCINNATI DAYTON RD STE R, WEST CHESTER, OH 45069-6630
(937) 586-7729
Mailing address
273 REGENCY RIDGE DR, CENTERVILLE, OH 45459-4221
(724) 622-8895
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
09/22/2022
Last updated
04/19/2023
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