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General NPI Number Information
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NPI Number | 1164689378
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Entity Type | Organization
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Legal Business Name | JAMES L. DIXON, DMD, PS
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Dates
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Enumeration Date | 05/16/2008
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Last Update Date | 05/16/2008
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Provider Practice Location Address
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Address Line | 2520 PERRY AVE STE A
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City | BREMERTON
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State | WA
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Zip | 98310-5219
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Country | US
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Telephone | 360-479-2240
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Fax | 360-792-5952
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Provider Business Mailing Address
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Address Line | 2520 PERRY AVE STE A
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City | BREMERTON
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State | WA
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Zip | 98310-5219
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Country | US
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Telephone | 360-479-2240
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Fax | 360-792-5952
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Authorized Official
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Title or Position | DENTIST PRESIDENT OWNER
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Name | DR. JAMES LORNE DIXON
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Credential | DDS, PS
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Telephone | 360-479-2240
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 4334
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License Number State | WA
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