Individual
CHRISTOPHER JOHN JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
503 JACKSON ST, BELLE FOURCHE, SD 57717-1716
(605) 892-6347
(605) 892-6564
Mailing address
503 JACKSON ST, BELLE FOURCHE, SD 57717-1716
(605) 892-6347
(605) 892-6564
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D0633
SD
Other
Enumeration date
06/12/2007
Last updated
07/08/2007
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