Organization
DENTISTRY FOR KIDS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS WESLEY JACKSON D.M.D (OWNER)
(412) 367-2250
Entity
Organization
Contact information
Practice address
244 COLLEGE AVE, BEAVER, PA 15009-2706
(724) 888-2684
(724) 709-8061
Mailing address
2790 MOSSIDE BLVD, SUITE 140, MONROEVILLE, PA 15146-2743
(412) 367-2250
(412) 367-0930
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
DS026194L
PA
Other
Enumeration date
12/03/2015
Last updated
12/03/2015
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