Individual
DR. JACKSON A BEAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
2704 AILEEN BLVD, GREENVILLE, TX 75402-6486
(903) 454-6661
(903) 454-6661
Mailing address
2704 AILEEN BLVD, GREENVILLE, TX 75402-6486
(903) 454-6661
(903) 454-6661
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
21382
TX
Other
Enumeration date
04/20/2007
Last updated
03/11/2013
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