Individual
JACQUES DUPRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6958 NEBRASKA AVE, FORT LEONARD WOOD, MO 65473-1618
(573) 596-0411
Mailing address
6958 NEBRASKA AVENUE, FORT LEONARD WOOD, MO 65473
(573) 596-0411
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
019029993
IL
122300000X
Dentist
319019139
IL
1223G0001X
General Practice Dentistry
2024009465
MO
1223G0001X
General Practice Dentistry
Primary
7910
OK
Other
Enumeration date
08/13/2014
Last updated
08/23/2024
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