Individual
DR. RODNEY ALLEN JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2517 SIR BARTON WAY STE 200, LEXINGTON, KY 40509-2275
(859) 543-2456
(859) 543-2373
Mailing address
2517 SIR BARTON WAY STE 200, LEXINGTON, KY 40509-2275
(859) 543-2456
(859) 543-2373
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
7750
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
60002201
—
KY
Enumeration date
09/13/2006
Last updated
07/08/2007
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