Provider Demographics
NPI:1851304349
Name:JARVIS, JEFFREY BRUCE (DDS MS)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:BRUCE
Last Name:JARVIS
Suffix:
Gender:M
Credentials:DDS MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 WASHINGTON HEIGHTS MED CTR
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:MD
Mailing Address - Zip Code:21157-5632
Mailing Address - Country:US
Mailing Address - Phone:410-848-6700
Mailing Address - Fax:
Practice Address - Street 1:207 WASHINGTON HEIGHTS MED CTR
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157-5632
Practice Address - Country:US
Practice Address - Phone:410-848-6700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2009-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD120601223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics