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Organization

DENTISTRY FOR KIDS

Active
Parent organization
THOMAS W. JACKSON INC.
Organization subpart
Yes

Provider details

NPI number
Legal business name
THOMAS W. JACKSON INC.
Authorized official
DR. PAUL J. BRORING D.D.S, (PEDISTRIC DENTIST)
(412) 682-7900
Entity
Organization

Contact information

Practice address
4815 LIBERTY AVE, SUITE 106, PITTSBURGH, PA 15224
(412) 682-7900
(412) 682-7954
Mailing address
4815 LIBERTY AVE, SUITE 106, PITTSBURGH, PA 15224
(412) 682-7900
(412) 682-7954

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
DS038177
MD

Other

Enumeration date
12/08/2011
Last updated
12/08/2011
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