Jake Modery, D.D.S.

NPI #1205217445 in Amarillo, Texas

Provider Information

NPI Number: 1205217445
Entity Type: Individual
Name: Jake Modery, D.D.S.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist
Credential: D.D.S.
Enumeration Date: Jun 13, 2015
Last Updated: Sep 1, 2016

Practice Location

Address: 9200 TOWN SQUARE BLVD
Address 2: SUITE 1090
City: Amarillo
State: Texas
ZIP Code: 79119-1250
Phone: (806) 731-1180

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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