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Individual

DR. E PENN JACKSON JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
155 E SONTERRA BLVD, #205, SAN ANTONIO, TX 78258
(210) 341-3222
(210) 341-8607
Mailing address
155 E SONTERRA BLVD, #205, SAN ANTONIO, TX 78258
(210) 341-3222
(210) 341-8607

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
14069
TX

Other

Enumeration date
10/12/2006
Last updated
07/08/2007
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