Organization
JACKSON DENTAL PROF. LLC
Active
Other names
John H Jackson DDS PC
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER J JACKSON DMD (PRESIDENT)
(605) 892-6347
Entity
Organization
Contact information
Practice address
503 JACKSON ST, BELLE FOURCHE, SD 57717
(605) 892-6347
(605) 892-9027
Mailing address
503 JACKSON ST, BELLE FOURCHE, SD 57717
(605) 892-6347
(605) 892-9027
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
D0633
SD
122300000X
Dentist
Primary
M525
SD
Other
Enumeration date
11/17/2006
Last updated
11/03/2010
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