Organization
JOHN P. JACKSON D.D.S., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN P JACKSON D.D.S. (PRESIDENT)
(573) 756-6415
Entity
Organization
Contact information
Practice address
109 S FRANKLIN ST, FARMINGTON, MO 63640-2516
(573) 756-6415
(573) 756-6416
Mailing address
109 S FRANKLIN ST, FARMINGTON, MO 63640-2516
(573) 756-6415
(573) 756-6416
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
11953
MO
Other
Enumeration date
05/22/2007
Last updated
10/01/2007
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