Individual
DR. JACK T EMORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
66 SPRINGER DR STE 204, HIGHLANDS RANCH, CO 80129-2307
(303) 791-0472
Mailing address
4321 OLD WINDMILL WAY, CASTLE ROCK, CO 80109-8656
(314) 603-3406
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
00204600
CO
1223G0001X
General Practice Dentistry
2020025847
MO
1223G0001X
General Practice Dentistry
61675
KS
Other
Enumeration date
07/28/2020
Last updated
01/17/2026
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