Organization Name: | JASON K POTTER MD DDS PA |
NPI Number: | 1164608709 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JASON K POTTER (OWNER) |
Mailing Address: | 8220 Walnut Hill Ln Suite 206 Dallas |
State: | TX US |
Postal Code: | 752314427 |
Phone Number: | 2149306588 |
Fax Number: | |
NPI Enumeration Date: | 01/14/2008 |
NPI Last Update Date: | 10/22/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | M6345 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |