Individual
DR. JADE ON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
2225 N HARWOOD ST, DALLAS, TX 75201
(757) 642-3569
Mailing address
2225 N HARWOOD ST, DALLAS, TX 75201-2380
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
33145
TX
1223G0001X
General Practice Dentistry
33145
TX
Other
Enumeration date
06/19/2017
Last updated
07/14/2018
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