Individual
DR. JOSEPH L JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS, MS
Contact information
Practice address
1241 RIVERSIDE AVE, FORT COLLINS, CO 80524-3204
(317) 370-9529
Mailing address
1241 RIVERSIDE AVE, FORT COLLINS, CO 80524-3204
(317) 370-9529
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
00204350
CO
Other
Enumeration date
04/10/2010
Last updated
08/12/2020
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