| Scott Jacks, Dds, Inc | |
|
4354 Tweedy Blvd South Gate CA 90280-6237 | |
| (323) 564-2444 | |
| (323) 249-7565 |
| Full Name | Scott Jacks, Dds, Inc |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 4354 Tweedy Blvd, South Gate, California |
| Authorized Official Name and Position | Jerry David Minsky (OWNER) |
| Authorized Official Contact | 3235642444 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Scott Jacks, Dds, Inc 4354 Tweedy Blvd South Gate CA 90280-6237 Ph: (323) 564-2444 | Scott Jacks, Dds, Inc 4354 Tweedy Blvd South Gate CA 90280-6237 Ph: (323) 564-2444 |
| NPI Number | 1194928614 |
|---|---|
| Provider Enumeration Date | 06/11/2007 |
| Last Update Date | 09/16/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194928614 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 31668 (California) | Primary |
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