Individual
MARCUS JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
8847 VETERANS MEMORIAL BLVD STE B, METAIRIE, LA 70003-7707
(504) 466-2392
Mailing address
8847 VETERANS MEMORIAL BLVD STE B, METAIRIE, LA 70003-7707
(504) 466-2392
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
2489-89
LA
1223G0001X
General Practice Dentistry
Primary
2489-89
MS
1223G0001X
General Practice Dentistry
5619
LA
Other
Enumeration date
01/04/2007
Last updated
02/03/2023
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