Provider Demographics
NPI:1689766438
Name:OUSLEY, JON S (DDS MSD)
Entity Type:Individual
Prefix:
First Name:JON
Middle Name:S
Last Name:OUSLEY
Suffix:
Gender:M
Credentials:DDS MSD
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Mailing Address - Street 1:7005 PASTOR BAILEY DR
Mailing Address - Street 2:SUITE 100A
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75237
Mailing Address - Country:US
Mailing Address - Phone:972-296-1835
Mailing Address - Fax:972-296-1867
Practice Address - Street 1:7005 PASTOR BAILEY DR
Practice Address - Street 2:SUITE 100A
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75237
Practice Address - Country:US
Practice Address - Phone:972-296-1835
Practice Address - Fax:972-296-1867
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2011-12-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TX83461223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00948501Medicaid