Individual
DR. VELMA H JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
4343 NORTH BLVD, BATON ROUGE, LA 70806-3916
(225) 343-3459
(225) 344-7755
Mailing address
4343 NORTH BLVD, BATON ROUGE, LA 70806-3916
(225) 343-3459
(225) 344-7755
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2537
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1825379
—
LA
Enumeration date
04/20/2007
Last updated
07/09/2007
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