Individual
DR. RICHARD FREDRICK JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DD.S.
Contact information
Practice address
1441 SECRET RAVINE PKWY, SUITE 160, ROSEVILLE, CA 95661-6044
(916) 787-1515
(916) 787-1516
Mailing address
1441 SECRET RAVINE PKWY, SUITE 160, ROSEVILLE, CA 95661-6044
(916) 787-1515
(916) 787-1516
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
24465
CA
Other
Enumeration date
10/10/2006
Last updated
06/05/2015
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