Individual
DR. WILLIAM J. JAGGER
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
510 COLORADO AVE, PUEBLO, CO 81004-2013
(719) 543-1132
(719) 543-1132
Mailing address
510 COLORADO AVE, PUEBLO, CO 81004-2013
(719) 543-1132
(719) 543-1132
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2594
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02025948
—
CO
01
—
813547
UNITED CONCORDIA ID
CO
Enumeration date
05/15/2006
Last updated
07/09/2007
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