Individual
DR. JON CHARLES PACKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1316 DAVIE AVE, STATESVILLE, NC 28677-3561
(704) 873-2211
Mailing address
104 BILLINSGATE CT, MOORESVILLE, NC 28117-6702
(704) 799-7552
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7159
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
899015P
—
NC
Enumeration date
06/30/2006
Last updated
07/09/2007
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