Individual
JACKELINE PEREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1661 W 2ND AVE, CORSICANA, TX 75110-4107
(903) 872-1661
Mailing address
3909 LIVINGSTON AVE, FORT WORTH, TX 76110-6063
(817) 204-7514
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
41577
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/06/2023
Last updated
07/30/2025
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