Individual
DR. PETER FOLEY JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
100 N ACADEY AVE, DANVILLE, PA 17822-1336
(570) 271-6355
Mailing address
100 N ACADEMY AVE, DANVILLE, PA 17822-4903
(570) 271-6144
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
0401412820
VA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DS039530
PA
124Q00000X
Dental Hygienist
DS039530
PA
Other
Enumeration date
03/19/2008
Last updated
08/21/2020
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