Individual
DR. JEREMY RICHARD KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1293 E MCANDREWS RD, MEDFORD, OR 97504-6103
(541) 772-1215
(541) 772-3210
Mailing address
1293 E MCANDREWS RD, MEDFORD, OR 97504-6103
(541) 772-1215
(541) 772-3210
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D8487
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001640757
UNITED CONCORDIA
PA
Enumeration date
07/25/2008
Last updated
07/25/2008
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