Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 17038 | MI |
NPI | 1003914326 |
---|---|
Provider Name | Dr. Jason John Armstrong |
First Address | Dearborn, MI 48128-1131 |
Second Address | Dearborn, MI 48128-1131 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2006 |
Last Update Date | 02/11/2021 |