Organization
KYLE R. JACKSON, DDS, LLC
Active
Other names
Keep Smiling Kids
Organization subpart
No
Provider details
NPI number
Authorized official
KYLE R. JACKSON DDS (OWNER)
(937) 586-7729
Entity
Organization
Contact information
Practice address
4090 INDIAN RIPPLE RD UNIT 102, BEAVERCREEK, OH 45440-3253
(937) 586-7729
(937) 490-9904
Mailing address
273 REGENCY RIDGE DR, CENTERVILLE, OH 45459-4221
(937) 586-7729
(937) 660-4450
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
06/06/2019
Last updated
06/06/2019
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