Individual
DR. JASON JOHN TUPPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BDS
Contact information
Practice address
600 COUNTRY CLUB VW STE 4, EDWARDSVILLE, IL 62025-3638
(618) 307-3267
Mailing address
4101 LACLEDE AVE UNIT 211, SAINT LOUIS, MO 63108-2998
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2025011907
MO
1223P0700X
Prosthodontics
019.036573
IL
Other
Enumeration date
08/04/2022
Last updated
10/22/2025
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