Individual
DR. WILLIAM RICHARD JACKOMIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S., J.D.
Contact information
Practice address
46161 WESTLAKE DR, SUITE 110, POTOMAC FALLS, VA 20165-5871
(703) 444-9244
(703) 444-9497
Mailing address
46161 WESTLAKE DR, SUITE 110, POTOMAC FALLS, VA 20165-5871
(703) 444-9244
(703) 444-9497
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401410251
VA
Other
Enumeration date
01/31/2007
Last updated
07/08/2007
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