Individual
DANA MARIE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
101 S STATE HIGHWAY 125, STRAFFORD, MO 65757-8997
(417) 631-4490
Mailing address
6950 NE CAMPUS WAY, HILLSBORO, OR 97124-5611
(618) 560-8849
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2023031197
MO
1223G0001X
General Practice Dentistry
2023031197
MO
Other
Enumeration date
09/08/2014
Last updated
08/31/2023
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