Provider Demographics
NPI:1356522205
Name:REDMOND, JACK WILLIAM II (DDS MA)
Entity type:Individual
Prefix:DR
First Name:JACK
Middle Name:WILLIAM
Last Name:REDMOND
Suffix:II
Gender:M
Credentials:DDS MA
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Mailing Address - Street 1:451 WEST GONZALES ROAD
Mailing Address - Street 2:SUITE 320
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93036
Mailing Address - Country:US
Mailing Address - Phone:805-485-5150
Mailing Address - Fax:805-485-5780
Practice Address - Street 1:451 WEST GONZALES ROAD
Practice Address - Street 2:SUITE 320
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93036
Practice Address - Country:US
Practice Address - Phone:805-485-5150
Practice Address - Fax:805-485-5780
Is Sole Proprietor?:No
Enumeration Date:2007-11-20
Last Update Date:2007-11-20
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Provider Licenses
StateLicense IDTaxonomies
CA234561223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics