Individual
MR. LEONARD VICTOR JACKSON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
520 NORTH 12TH STREET, SUITE #406, RICHMOND, VA 23298-0566
(804) 828-2977
(804) 828-3159
Mailing address
520 N. 12TH STREET, SUITE #406, RICHMOND, VA 23298-0566
(804) 828-2977
(804) 828-3159
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401411640
VA
Other
Enumeration date
04/20/2007
Last updated
01/28/2011
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