Individual
CARY V JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
2612 W BROADWAY, COUNCIL BLUFFS, IA 51501-3510
(712) 323-3615
(712) 325-6155
Mailing address
2612 W BROADWAY, COUNCIL BLUFFS, IA 51501-3510
(712) 323-3615
(712) 325-6155
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
08576
IA
Other
Enumeration date
08/01/2008
Last updated
10/29/2024
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