Provider Demographics
NPI:1174089577
Name:J&A DENTAL PARTNERS
Entity type:Organization
Organization Name:J&A DENTAL PARTNERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DDS
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:COLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-687-7496
Mailing Address - Street 1:1905 PINON HILLS CT
Mailing Address - Street 2:
Mailing Address - City:PFLUGERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78660-5065
Mailing Address - Country:US
Mailing Address - Phone:847-687-7496
Mailing Address - Fax:
Practice Address - Street 1:5940 KYLE PKWY STE 105
Practice Address - Street 2:
Practice Address - City:KYLE
Practice Address - State:TX
Practice Address - Zip Code:78640-2482
Practice Address - Country:US
Practice Address - Phone:847-687-7496
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-11
Last Update Date:2019-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty