Potter, Jason K

Potter, Jason K is an individual health care provider with primary practice located at 8220 Walnut Hill Ln Suite 206, Dallas TX 75231-4427. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery, Other Service Providers / Specialist, Dental Providers / Oral and Maxillofacial Surgery. Other Service Providers / Specialist is his primary health care specialty. Potter, Jason K can be contacted via phone (214) 930-6588.

Contact Information

Primary practice address
8220 Walnut Hill Ln Suite 206 Dallas TX 75231-4427
Phone: (214) 930-6588
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery 204E00000X MD25735 Oregon
Other Service Providers / Specialist 174400000X M6345 Texas
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X M6345 Texas

Profile Details

NPI number 1467449207
LBN Legal business name Potter, Jason K
Credentials M.D., D.D.S.
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 5th, 2005
Last updated Oct 22nd, 2008 - about 16 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1467449207 NPPES
Oregon MEDICAID 269840

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