Jackson Canter

NPI #1396362497 in Beardstown, Illinois

Provider Information

NPI Number: 1396362497
Entity Type: Individual
Name: Jackson Canter
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist
Enumeration Date: Jul 6, 2020
Last Updated: Jul 6, 2020

Practice Location

Address: 507 WASHINGTON ST
City: Beardstown
State: Illinois
ZIP Code: 62618-1558
Phone: (217) 323-2701

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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