Individual
CHRISTOPHER R JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3930 TANGLEWOOD LN, ODESSA, TX 79762-7165
(432) 366-0896
Mailing address
1501 W WALL ST, MIDLAND, TX 79701-6525
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
36092
TX
122300000X
Dentist
D-5055
ID
Other
Enumeration date
07/03/2019
Last updated
01/18/2025
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