Individual
DR. BRIAN JOSEPH JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
2534 GENESEE ST, UTICA, NY 13502-5814
(315) 724-5141
(315) 733-1270
Mailing address
2534 GENESEE ST, UTICA, NY 13502-5814
(315) 724-5141
(315) 733-1270
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
042719
NY
Other
Enumeration date
11/20/2006
Last updated
07/08/2007
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