Individual
DR. JOHN ROBERT JEROME
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
11462 MIRO CIR, SAN DIEGO, CA 92131
(858) 577-7856
Mailing address
11462 MIRO CIR, SAN DIEGO, CA 92131-3315
(858) 635-9154
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
55385
CA
Other
Enumeration date
02/06/2007
Last updated
04/10/2012
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