Individual
NATHANIEL JOSEPH JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
322 N ELM ST, OXFORD, OH 45056-1123
(513) 523-6267
Mailing address
36 MEADOW CIR, OXFORD, OH 45056-1585
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
025100
OH
Other
Enumeration date
05/22/2017
Last updated
05/22/2017
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