Individual
DR. DONALD WILLIAM JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1909 A MISSION 66, VICKSBURG, MS 39180-3711
(601) 636-8003
(601) 638-9602
Mailing address
1909 A MISSION 66, VICKSBURG, MS 39180-3711
(601) 636-8003
(601) 638-9602
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
184079
MS
Other
Enumeration date
03/27/2007
Last updated
07/08/2007
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