Jessica Rose White Harvey, DDS

Individual provider Active NPI General Practice Dentistry · Jbsa Lackland Afb, TX

NPI 1063727022 · NPPES record last updated Jan 18, 2024

Key facts

NPI
1063727022
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
0401412982 (VA)
Practice address
1100 Wilford Hall Loop
Jbsa Lackland Afb, TX 78236-5638
Phone
(210) 292-0123
NPI assigned
Aug 16, 2010
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
0401412982VAMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 0401412982 VA Yes

Addresses

Primary practice location

1100 Wilford Hall Loop
Jbsa Lackland Afb, TX 78236-5638

Mailing address

3346 Clearwater Dr
Clarksville, TN 37042-4550
Phone (931) 206-0614

Other providers in Jbsa Lackland Afb, TX

All providers in Jbsa Lackland Afb, TX · General Practice Dentistry in Texas

Sources for this page

Verify at the official NPI Registry.