OrganizationJon Douglas Lesan Dds Rph PaDentistDental ProvidersPractice Address123 Cobia Ct, Jacksonville, NC 28546-6862(910) 347-1211PECOS EnrollmentBased on the most recent information from CMS, provider Jon Douglas Lesan Dds Rph Pa 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 11:51 AM.Profile DetailsProvider ID1952479156Provider TypeOrganizationFull NameJon Douglas Lesan Dds Rph PaSubpartNoEnumeration Date12/4/2006Last Updated3/7/2023Contact InformationPractice LocationPractice Address123 Cobia Ct, Jacksonville, NC 28546-6862Phone(910) 347-1211Fax(910) 347-0765Mailing LocationMailing Address123 Cobia Ct, Jacksonville, NC 28546-6862Phone(910) 347-1211Fax(910) 347-0765Authorized OfficialNameLesan, Jon Douglas (Owner Dentist)Phone(910) 347-1211Provider TaxonomiesCodeDescriptionLicenseCode1223G0001XPrimaryDescriptionDentistDental ProvidersLicenseUnlisted IssuerNorth CarolinaCode332B00000XDescriptionDurable Medical Equipment & Medical SuppliesSuppliersLicenseUnlisted Issuer