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A PLACE TO SMILE JONATHAN JACKSON DDS LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JONATHAN D JACKSON DDS (DENTIST)
(801) 489-6811
Entity
Organization

Contact information

Practice address
485 S MAIN ST STE 302, SPRINGVILLE, UT 84663-2290
(801) 489-6811
(801) 489-6840
Mailing address
485 S MAIN ST STE 302, SPRINGVILLE, UT 84663-2290
(801) 489-6811
(801) 489-6840

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
7025515
UT

Other

Enumeration date
01/25/2018
Last updated
01/25/2018
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