Individual
DR. PAUL S. JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
26 SOUTH 200 EAST, SUITE 5900, SALT LAKE CITY, UT 84112
(801) 585-6485
Mailing address
4237 CUMBERLAND RD, HOLLADAY, UT 84124-2737
(801) 671-6228
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
06/03/2009
Last updated
06/03/2009
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