Organization
LLOYD BRENT JACKSON DMD PALLC
Active
Other names
Farmington Dental Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LLOYD BRENT JACKSON DMD (OWNER DENTIST)
(505) 327-0044
Entity
Organization
Contact information
Practice address
2700 FARMINGTON AVE, SUITE C-1, FARMINTON, NM 87401-4550
(505) 327-0044
(505) 325-0817
Mailing address
2700 FARMINGTON AVE, SUITE C-1, FARMINTON, NM 87401-4550
(505) 327-0044
(505) 325-0817
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
09/11/2006
Last updated
08/22/2020
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