Individual
JONATHAN JAMES DISMUKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
36000 DARNALL LOOP RM 1048, FORT HOOD, TX 76544-5095
(254) 287-2705
Mailing address
36000 DARNALL LOOP RM 1048, FORT HOOD, TX 76544-5095
(254) 287-2705
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D010128
AZ
Other
Enumeration date
08/02/2018
Last updated
07/19/2019
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