The Practice of Anesthesia & Gen. Dentistry
NPI #1417128042 in Roxbury, Massachusetts
Provider Information
- NPI Number
- 1417128042
- Entity Type
- Organization
- Organization Name
- The Practice of Anesthesia & Gen. Dentistry
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- LUE DEE JACKSON JR. DMD, MD DBA THE PRACTICE OF ANESTH. & GEN. DENT.
- Primary Specialty
- Clinic/Center - Dental
- Enumeration Date
- Mar 24, 2008
- Last Updated
- Mar 24, 2008
Practice Location
- Address
- 386 A/B WARREN STREET
- City
- Roxbury
- State
- Massachusetts
- ZIP Code
- 02119-0000
- Phone
- (800) 676-2750
Authorized Official
- Name
- LUE DEE JACKSON JR., DMD, MD
- Title
- GEN. DENTIST & ANESTHESIOLOGIST/OWN
- Phone
- (800) 676-2750
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Dental — Dental |
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