Individual
LAURA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
203 JAMESTOWN BLVD, ROGERSVILLE, MO 65742-6525
(417) 929-0000
Mailing address
408 JENNIFER LN, ROGERSVILLE, MO 65742-9743
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
2024022127
MO
Other
Enumeration date
08/11/2025
Last updated
08/11/2025
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