Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. JACK FREDRICK BACKS, D.M.D.
Active Sole ProprietorDR. JACK FREDRICK BACKS, D.M.D. is a General Dentistry healthcare provider located in HERMANN, Missouri. NPI 1104046556 is currently active in the NPPES registry. Verify at CMS.
General Dentistry · HERMANN, MO
Registration Details
- NPI Number
- 1104046556
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Apr 26, 2007 (19.259192364766 yrs)
- Last Updated
- Jul 8, 2007
- License
-
DE 015082 (MO)
- Sole Proprietor
- Yes
Practice Information
- Address
-
154 STATE ROUTE 100 WHERMANN, MO, 650411526Browse MO providers · Browse ZIP 65041
- Phone
- 5734863500
- Fax
- 5734863166
- Primary Specialty
-
General Dentistry
1223G0001X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.