Individual
DR. RICHARD L. JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
3650 ERIE AVE, CINCINNATI, OH 45208-1928
(513) 321-3037
(513) 321-2071
Mailing address
3650 ERIE AVE, CINCINNATI, OH 45208-1928
(513) 321-3037
(513) 321-2071
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
17359
OH
Other
Enumeration date
04/09/2007
Last updated
07/08/2007
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