Individual
DR. ANDREW P JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
806 JEFFERSON TER, NEW IBERIA, LA 70560
(337) 365-4945
Mailing address
806 JEFFERSON TER, NEW IBERIA, LA 70560-5727
(337) 365-4945
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4368
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1843687
—
LA
Enumeration date
06/09/2006
Last updated
10/16/2019
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