Jason R Bourne in Marysville - Orthodontics And Dentofacial Orthopedics
Jason R Bourne - NPI 1104922194
Jason R Bourne is a Orthodontics And Dentofacial Orthopedics in Marysville, Washington. Jason R Bourne practices all healthcare services and medical treatments related to Orthodontics And Dentofacial Orthopedics. The NPI Number for Jason R Bourne is 1104922194. The last update date is 2007-07-08.
Jason R Bourne's current location address is 815 State Ave, Marysville, Washington. You can contact this provider via phone number 3606590211 and fax number 3606580716. The mailing address for Jason R Bourne is 815 State Ave, Marysville, Washington. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Jason R Bourne |
|---|---|
| Address | 815 State Ave, Marysville, Washington |
| Phone Number | 3606590211 |
| Fax Number | 3606580716 |
| Sole Proprietor | N |
| Credentials | DDS, MS |
NPI Number Detail
| NPI Number | 1104922194 |
|---|---|
| Provider Enumeration Date | 2006-09-16 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 815 State Ave |
|---|---|
| City | Marysville |
| State | Washington (WA) |
| Post Code | 982704254 |
| Phone Number | 3606590211 |
| Fax Number | 3606580716 |
Provider's Primary Taxonomy Detail
| Speciality | Orthodontics And Dentofacial Orthopedics |
|---|---|
| Taxonomy | 1223X0400X |
| Licence No | DE00009603 |
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Definition: That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their rel |
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What is the unique identifier code issued to Jason R Bourne by the Centers for Medicare & Medicaid Services (CMS)?
The Jason R Bourne has been assigned the NPI (National Provider Identifier) 1104922194. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Where is the Jason R Bourne located?
The Jason R Bourne is located at 815 State Ave, Marysville, WA 982704254.
What is the Jason R Bourne's specialty and taxonomy code?
The Jason R Bourne's specialty is Orthodontics And Dentofacial Orthopedics, and the corresponding taxonomy code is 1223X0400X.
When did Jason R Bourne receive its 1104922194 assignment?
The Jason R Bourne was assigned its 1104922194 on 2006-09-16, which is the date when this unique identifier was issued to the organization.
As of what date were the details pertaining to Jason R Bourne last refreshed?
The information related to the Jason R Bourne, including its address, specialty, and other relevant details, was last updated on 2007-07-08.