Individual
DR. CHARLES B JACKSON, JR.
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS, MSD
Contact information
Practice address
669 UNION SQ, SANDY, UT 84070-3404
(801) 571-1231
(801) 571-9738
Mailing address
669 UNION SQ, SANDY, UT 84070-3404
(801) 571-1231
(801) 571-9738
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
142729-9921
UT
Other
Enumeration date
03/25/2006
Last updated
07/08/2007
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