Individual ProviderVonte JacksonStudent in an Organized Health Care Education/Training ProgramStudent, Health CarePractice Address1801 W Wisconsin Ave, Milwaukee, WI 53233-2186(414) 288-6790PECOS EnrollmentBased on the most recent information from CMS, provider Vonte Jackson does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1497321434Provider TypeIndividualFull NameJackson, VonteCredentialDDSGenderMaleSole ProprietorNoEnumeration Date6/1/2021Last Updated6/1/2021Contact InformationPractice LocationPractice Address1801 W Wisconsin Ave, Milwaukee, WI 53233-2186Phone(414) 288-6790FaxUnlisted FaxMailing LocationMailing Address1801 W Wisconsin Ave, Milwaukee, WI 53233-2186PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode390200000XPrimaryDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted Issuer