IndividualActive
Jackson Canter
NPI 1396362497 · Dentist · Beardstown, IL
Provider details
- NPI number
- 1396362497
- Entity type
- Individual
- Primary specialty
- DentistDental Providers
- Sex
- Male
- Sole proprietor
- No
- License
- 019032733 (IL)
Specialties & taxonomies
Dental Providers
Practice location
507 Washington St
Beardstown, IL 62618-1558
Phone: (217) 323-2701
Approximate (ZIP-level) locationGet directions
Mailing address
507 Washington St
Beardstown, IL 62618-1558
Registry dates
- Enumerated
- 2020-07-06
- Last updated
- 2020-07-06
- Certified
- 2020-07-06
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.