Jerry R Pearson, DMD
Dentist, General Practice in Phoenix, AZ. Individual provider (NPI-1).
NPI number1639192545
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1639192545
- Entity type
- Individual (NPI-1)
- Name
- Jerry R Pearson
- Credential
- DMD
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jul 25, 2006
- Last updated
- Jul 8, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | D5104 | AZ | Yes |
Practice location
1904 W Parkside LnSuite 201
Phoenix, AZ 85027-1228
Phone 623-434-9343 · Fax 623-321-6268
Mailing address
8104 N. 110th PlacePhoenix, AZ 85020
Phone 623-434-9343 · Fax 623-321-6268
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