Individual
DR. KYLE R. JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
273 REGENCY RIDGE DR, CENTERVILLE, OH 45459-4221
(937) 586-7729
(937) 660-4450
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
30-01-8976
OH
Other
Enumeration date
01/23/2006
Last updated
12/08/2016
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