Organization
CECILY L. JACKSON, DDS, P.C.
Active
Other names
Jackson Pediatric Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CECILY LYNN JACKSON DDS (REGISTERED AGENT/DIRECTOR)
(806) 789-9870
Entity
Organization
Contact information
Practice address
3233 63RD ST, SUITE A, LUBBOCK, TX 79413-5742
(806) 789-9870
Mailing address
21 W LAKESHORE DR, RANSOM CANYON, TX 79366-2517
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
24654
TX
Other
Enumeration date
08/03/2012
Last updated
08/03/2012
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