Individual
DUSTIN SEAN JANSSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
7515 QUAKER AVE, SUITE 100, LUBBOCK, TX 79424-5308
(806) 796-2408
(806) 686-6246
Mailing address
7515 QUAKER AVE, SUITE 100, LUBBOCK, TX 79424-5308
(806) 796-2408
(806) 686-6246
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
24601
TX
1223P0221X
Pediatric Dentistry
DD3138
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
319692501
—
TX
05
—
319692502
—
TX
05
—
3196933
—
TX
Enumeration date
06/04/2009
Last updated
10/15/2015
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