Individual
DR. RATRICE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1932 N STORY RD, IRVING, TX 75061-1936
(469) 299-5437
Mailing address
1932 N STORY RD, IRVING, TX 75061-1936
(501) 765-0313
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
35968
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/08/2018
Last updated
06/05/2020
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