Organization · Type 2 NPI

Bruce A. Jackson Ii, Dds, PLC

Dental Clinic/Center · Grand Rapids, MI

NPI number 1639783137 Active

Practice location

4829 E Beltline Ave NE
Grand Rapids, MI 49525-9747

Specialties and licenses

TaxonomyCodeLicense
Dental Clinic/Center Primary 261QD0000XNone listed

Dental Clinic/Center: Definition to come...

25 other providers at this address

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About NPI 1639783137

Bruce A. Jackson Ii, Dds, PLC's National Provider Identifier is 1639783137, issued on Sep 2, 2020. The primary taxonomy on file is Dental Clinic/Center (261QD0000X), and the practice location is in Grand Rapids, MI. The record was last updated on Sep 2, 2020.