Individual
CHELSEA LYNN JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
42201 N 41ST DR STE 156, ANTHEM, AZ 85086-3803
(623) 551-3511
Mailing address
2234 W WEBSTER CT, ANTHEM, AZ 85086-1854
(602) 405-5998
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
30.025964
OH
122300000X
Dentist
Primary
D010374
AZ
Other
Enumeration date
08/26/2019
Last updated
11/15/2021
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