Individual
RYNE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD, MSD
Contact information
Practice address
15294 W BROOKSIDE LN STE 100, SURPRISE, AZ 85374-2446
(623) 376-7400
Mailing address
24125 N 160TH AVE, SURPRISE, AZ 85387-1629
(480) 353-6476
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
7005
LA
1223E0200X
Endodontics
Primary
D012024
AZ
Other
Enumeration date
06/24/2019
Last updated
07/14/2025
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