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General NPI Number Information
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NPI Number | 1396406567
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Entity Type | Organization
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Legal Business Name | JACKSON DMD & SAYRE DMD, PLLC
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Dates
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Enumeration Date | 01/10/2022
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Last Update Date | 01/10/2022
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Provider Practice Location Address
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Address Line | 76 PEACHTREE RD STE 100
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City | ASHEVILLE
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State | NC
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Zip | 28803-5041
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Country | US
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Telephone | 828-277-6788
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Fax | 828-277-6798
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Provider Business Mailing Address
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Address Line | 76 PEACHTREE RD STE 100
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City | ASHEVILLE
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State | NC
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Zip | 28803-5041
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Country | US
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Telephone | 828-277-6788
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Fax | 828-277-6798
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Authorized Official
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Title or Position | ADMINISTRATIVE ASSISTANT
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Name | CARRIE ANN DUTCHER
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Credential |
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Telephone | 828-277-6788
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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