Individual
DR. RALPH DUDLEY JACKSON III
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1400 METRO DR, ALEXANDRIA, LA 71301-3451
(318) 487-0075
(318) 487-0958
Mailing address
6201 BRADFORD DR, ALEXANDRIA, LA 71303-2382
(318) 449-8621
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
5337
LA
Other
Enumeration date
10/31/2005
Last updated
07/08/2007
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