Organization
DENTISTRY FOR KIDS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS W JACKSON DMD (PRESIDENT)
(412) 367-2250
Entity
Organization
Contact information
Practice address
3472 ROUTE 130, HARRISON CITY, PA 15636
(412) 367-2250
(412) 367-4060
Mailing address
8160 PERRY HWY, PITTSBURGH, PA 15237-5214
(412) 367-2250
(412) 367-4060
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
168020
UNITED CONCORDIA NUMBER
PA
Enumeration date
02/01/2007
Last updated
08/06/2008
Update your record
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