Jeanson, David Timothy
Jeanson, David Timothy is an sole proprietor health care provider with primary practice located at 235 Perry Ave , Racine WI 53406. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Jeanson, David Timothy can be contacted via phone (262) 637-6381.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | 2532 | Wisconsin |
Profile Details
| NPI number | 1841371119 |
|---|---|
| LBN Legal business name | Jeanson, David Timothy |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 17th, 2006 |
| Last updated | May 10th, 2016 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1841371119 | NPPES |
| Wisconsin | MEDICAID | 33422300 |
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