Matt T Jam, D.D.S
Dentist, General Practice in Indio, CA. Individual provider (NPI-1).
NPI number1710049366
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1710049366
- Entity type
- Individual (NPI-1)
- Name
- Matt T Jam
- Credential
- D.D.S
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Dec 13, 2006
- Last updated
- Jul 8, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | 37294 | CA | Yes |
Practice location
81730 Hyway 111Suite 8
Indio, CA 92201
Phone 760-347-7505 · Fax 760-347-6425
Mailing address
81730 Hwy 111Suite 8
Indio, CA 92201
Phone 760-347-7505 · Fax 760-347-6425
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