Individual
DR. JONATHAN D JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
335 E 400 S, SPRINGVILLE, UT 84663-1959
(801) 489-4411
Mailing address
51 N 850 E, LINDON, UT 84042-2154
(304) 288-4574
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7025515-9921
UT
Other
Enumeration date
06/06/2008
Last updated
07/23/2008
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