Provider Demographics
NPI:1770815425
Name:MCPHERSON, JESSICA ANN (DDS)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:ANN
Last Name:MCPHERSON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 BROAD ST
Mailing Address - Street 2:
Mailing Address - City:WEYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02188-2337
Mailing Address - Country:US
Mailing Address - Phone:781-335-1576
Mailing Address - Fax:781-335-8401
Practice Address - Street 1:130 BROAD ST
Practice Address - Street 2:
Practice Address - City:WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02188-2337
Practice Address - Country:US
Practice Address - Phone:781-335-1576
Practice Address - Fax:781-335-8401
Is Sole Proprietor?:No
Enumeration Date:2010-02-05
Last Update Date:2019-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD14573122300000X
MA1856669122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist