Organization
DR. JON C. PACKMAN PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JON CHARLES PACKMAN DDS (DENTIST)
(704) 873-2211
Entity
Organization
Contact information
Practice address
1316 DAVIE AVE STE A, STATESVILLE, NC 28677-3561
(704) 873-2211
Mailing address
104 BILLINSGATE CT, MOORESVILLE, NC 28117-6702
(704) 799-7552
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7159
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
899015P
—
NC
Enumeration date
09/28/2006
Last updated
07/03/2013
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