Dr. James Jack
Dentist in Aurora, CO. Individual provider (NPI-1).
NPI number1295048841
StatusActive
Last updated in NPPESJul 23, 2010
Details
- NPI
- 1295048841
- Entity type
- Individual (NPI-1)
- Name
- Dr. James Jack
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jul 23, 2010
- Last updated
- Jul 23, 2010
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | 70 | CO | Yes |
Practice location
13065 E 17th AveAurora, CO 80045-2532
Phone 303-724-7110
Mailing address
13065 E 17th AveAurora, CO 80045-2532
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