Dr Brandon Jackson Pediatric Dental Pllc
Specialty details in registry · Staten Island, NY
At a glance
821 Clove Rd, Staten Island, NY 10310-2839
NPPES record updated Dec 9, 2022. Public records can lag behind changes at a practice.
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Practice location
821 Clove RdStaten Island, NY 10310-2839
Professional details: NPI, taxonomy & registry record
Registry details
- Primary taxonomy
- Specialty details in registry
- Taxonomy code
- 1223P0221X
- Enumeration date
- Dec 9, 2022
- Record updated
- Dec 9, 2022
More registry details
- Provider type
- Organization · Type 2
Reported taxonomies and licenses
Specialty details in registry
1223P0221X · Primary
License numbers and credentials are reported to NPPES; HCPList does not independently verify them.
Practice location
821 Clove RdStaten Island, NY 10310-2839
- Phone
- (718) 448-0976
Mailing address
70 VIRGINIA AVESTATEN ISLAND, NY 103051748
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