Individual
DR. JACK THOMAS MCCALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
812 S. 24TH ST., BETHANY, MO 64424-1322
(660) 425-3331
Mailing address
812 S. 24TH ST., BETHANY, MO 64424-1322
(660) 425-3331
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2008014150
MO
Other
Enumeration date
06/04/2008
Last updated
11/11/2008
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