Individual
DR. REMIGIUS JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
12101 DESSAU RD, APT 1108, AUSTIN, TX 78754-2073
(337) 274-1370
Mailing address
12101 DESSAU RD, APT 1108, AUSTIN, TX 78754-2073
(337) 274-1370
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
27911
TX
Other
Enumeration date
05/25/2012
Last updated
08/08/2012
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