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Organization
SCOTT ROBERT JACKSON DDS PC
Active
Organization
SCOTT ROBERT JACKSON DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SCOTT ROBERT JACKSON DDS PC (PRESIDENT)
(623) 933-0550
Entity
Organization
Contact information
Practice address
13660 N 94TH DR, SUITE A1 PLAZA DEL RIO MEDICAL CENTER, PEORIA, AZ 85381-4836
(623) 933-0550
(623) 933-2722
Mailing address
13660 N 94TH DR, SUITE #A1, PEORIA, AZ 85381-4836
(623) 933-0550
(623) 933-2722
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2532
AZ
Other
Enumeration date
10/04/2006
Last updated
08/22/2020
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