Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Bruce A. Jackson II, DDS, PLC

Organization Dental Clinic/Center · NPI 1639783137

Bruce A. Jackson II, DDS, PLC is a Dental Clinic/Center in Grand Rapids, Michigan. Registered with an NPI since 2020.

In the registry since
2020

Practice location Address checks out

4829 E Beltline Ave NE
Grand Rapids, MI 49525-9747
Phone: (616) 363-8707
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dental Clinic/Center (primary) Taxonomy 261QD0000X

Record details

NPI number1639783137
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Bruce Jackson — Owner · (616) 363-8707
NPI enumeratedSeptember 2, 2020
Last updated in NPPESSeptember 2, 2020
Certification dateSeptember 2, 2020
Mailing address4829 E Beltline Ave Ne, Grand Rapids, MI 49525-9747

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