Individual
DR. JASON PENDLETON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S
Contact information
Practice address
1637 MAIN ST, ONALASKA, WI 54650
(608) 781-3999
Mailing address
1637 MAIN ST, ONALASKA, WI 54650-2853
(608) 781-3999
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
711815
WI
390200000X
Student in an Organized Health Care Education/Training Program
30353
IA
Other
Enumeration date
04/22/2012
Last updated
12/08/2015
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