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1194027698
JACK ROSS ACHEATEL
NORTHRIDGE, CA
NPI
1194027698
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: CA 20143)
Enumeration Date
2010-12-03
Last Update Date
2010-12-03
Business Address
-- JACK ROSS ACHEATEL
18856 ROSCOE BLVD
NORTHRIDGE, CA 91324
Phone number: 818-885-7116
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Mailing Address
-- JACK ROSS ACHEATEL
18856 ROSCOE BLVD
NORTHRIDGE, CA 91324
Phone number: 818-885-7116
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