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Organization
FURQUERON & JACKSON DENTISTRY PARTNERSHIP
Active
Organization
FURQUERON & JACKSON DENTISTRY PARTNERSHIP
Active
Other names
Henderson Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN C JACKSON D.D.S. (OWNER/PARTNER)
(903) 657-3139
Entity
Organization
Contact information
Practice address
1910 STATE HWY 43 EAST, HENDERSON, TX 75652
(903) 657-3139
(903) 655-0699
Mailing address
1910 STATE HWY 43 EAST, HENDERSON, TX 75652
(903) 657-3139
(903) 655-0699
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
19316
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0901829-02
—
TX
05
—
0901829-07
—
TX
05
—
1946717-07
—
TX
05
—
194671701
—
TX
Enumeration date
09/15/2010
Last updated
06/04/2012
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