Provider Demographics
NPI:1023007663
Name:JAEGER, JEFFREY J (DDS)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:J
Last Name:JAEGER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7240 BROOKLYN BLVD
Mailing Address - Street 2:SUITE 250
Mailing Address - City:BROOKLYN PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55429-1274
Mailing Address - Country:US
Mailing Address - Phone:763-561-1570
Mailing Address - Fax:763-560-4928
Practice Address - Street 1:7240 BROOKLYN BLVD
Practice Address - Street 2:SUITE 250
Practice Address - City:BROOKLYN PARK
Practice Address - State:MN
Practice Address - Zip Code:55429-1274
Practice Address - Country:US
Practice Address - Phone:763-561-1570
Practice Address - Fax:763-560-4928
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN99491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice