| J. Andrew Jackson, D.d.s. Ltd., Llp | |
|
600 Division, Suite E. San Antonio TX 78214 | |
| (210) 924-4279 | |
| (210) 924-4270 |
| Full Name | J. Andrew Jackson, D.d.s. Ltd., Llp |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 600 Division, Suite E., San Antonio, Texas |
| Authorized Official Name and Position | Misty Adamitz (OFFICE MGR.) |
| Authorized Official Contact | 2109244279 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| J. Andrew Jackson, D.d.s. Ltd., Llp 600 Division, Suite E. San Antonio TX 78214 Ph: (210) 924-4279 | J. Andrew Jackson, D.d.s. Ltd., Llp 600 Division, Suite E. San Antonio TX 78214 Ph: (210) 924-4279 |
| NPI Number | 1962734160 |
|---|---|
| Provider Enumeration Date | 02/12/2010 |
| Last Update Date | 02/12/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962734160 | NPI | - | NPPES |
| 651906 | Other | TX | PMI DELTA CARE |
| 784161 | Other | TX | UNITED CONCORDIA |
| 56539501 | Other | TX | AETNA |
| 1306300-05 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 14522 (Texas) | Primary |
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