Organization
CENTERVILLE OH - KYLE JACKSON DDS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAGGI EVANS (CREDENTIALING MANAGER)
(720) 603-4800
Entity
Organization
Contact information
Practice address
273 REGENCY RIDGE DR, CENTERVILLE, OH 45459-4221
(937) 586-7729
Mailing address
273 REGENCY RIDGE DR, CENTERVILLE, OH 45459-4221
(937) 586-7729
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
02/16/2026
Last updated
02/16/2026
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