Individual
CALLEN DEYOUNG JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
2139 HIGHWAY 471, BRANDON, MS 39047-8748
(769) 241-5807
(769) 241-5805
Mailing address
2139 HIGHWAY 471, BRANDON, MS 39047-8748
(769) 241-5807
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4276-22
MS
Other
Enumeration date
06/06/2022
Last updated
06/06/2022
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