Scott Jacks, Dds, INC

NPI #1336542851 in Baldwin Park, California

Provider Information

NPI Number: 1336542851
Entity Type: Organization
Organization Name: Scott Jacks, Dds, INC
Primary Specialty: Dentist
Enumeration Date: Sep 29, 2014
Last Updated: Nov 25, 2015

Practice Location

Address: 4138 MAINE AVE STE M2
City: Baldwin Park
State: California
ZIP Code: 91706-3302
Phone: (323) 564-2444

Authorized Official

Name: DR. JERRY DAVID MINSKY, D.D.S.
Title: PRESIDENT
Phone: (323) 564-2444

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - Pediatric Dentistry — Pediatric Dentistry	1223P0221X
Dentist - Orthodontics and Dentofacial Orthopedics — Orthodontics and Dentofacial Orthopedics	1223X0400X
Dentist	122300000X	Primary

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