Individual
DR. PAUL JOSEPH JACKANICH JR.
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
841 SOUTHWESTERN RUN, STE 1, POLANO, OH 44514
(330) 629-2270
(330) 629-2271
Mailing address
841 SOUTHWESTERN RUN, STE 1, POLAND, OH 44514-3688
(330) 629-2270
(330) 629-2271
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
18806
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0754125
—
OH
Enumeration date
05/05/2006
Last updated
07/08/2007
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