Individual
DR. DANA M JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
7101 PINES RD, SHREVEPORT, LA 71129-3403
(318) 686-2015
(318) 686-2018
Mailing address
7101 PINES RD, SHREVEPORT, LA 71129-3403
(318) 686-2015
(318) 686-2018
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5769
LA
1223G0001X
General Practice Dentistry
019-025879
IL
Other
Enumeration date
07/13/2006
Last updated
04/07/2015
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