Provider Demographics
NPI:1598868994
Name:PINKARD, JACQUES SCOTT (DDS MSD)
Entity Type:Individual
Prefix:
First Name:JACQUES
Middle Name:SCOTT
Last Name:PINKARD
Suffix:
Gender:M
Credentials:DDS MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1029 LINCOLN AVENUE
Mailing Address - Street 2:
Mailing Address - City:MARQUETTE
Mailing Address - State:MI
Mailing Address - Zip Code:49855-2620
Mailing Address - Country:US
Mailing Address - Phone:906-228-6310
Mailing Address - Fax:906-228-6345
Practice Address - Street 1:1029 LINCOLN AVENUE
Practice Address - Street 2:
Practice Address - City:MARQUETTE
Practice Address - State:MI
Practice Address - Zip Code:49855-2620
Practice Address - Country:US
Practice Address - Phone:906-228-6310
Practice Address - Fax:906-228-6345
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010136381223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics