Individual
MARCUS K JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
521 E MOUNTAIN VIEW AVE, ELLENSBURG, WA 98926-3865
(509) 933-2400
(509) 933-4804
Mailing address
501 S 5TH AVE, YAKIMA, WA 98902-3550
(509) 494-6700
(509) 573-6275
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DE61086594
WA
Other
Enumeration date
07/31/2020
Last updated
07/31/2020
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