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Individual

DR. ASHLEY R JACKSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DDS

Contact information

Practice address
123 W GROVE ST, EL DORADO, AR 71730-4608
(870) 864-0338
(870) 864-0229
Mailing address
123 W GROVE ST, EL DORADO, AR 71730-4608
(870) 864-0338
(870) 864-0229

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3443
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
152114608
AR
01
5X453
BLUE CROSS BLUE SHIELD
AR
Enumeration date
08/14/2006
Last updated
10/15/2007
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