Douglas Jackson, DDS Valid NPI

Individual provider · Dentist · Red Springs, NC

NPI

1457401762

Type

Individual (Type 1)

Primary specialty

Dentist

Specialty group

Dental Providers

Taxonomy code

122300000X

License number

3798 (NC)

Sex

Male

Sole proprietor

Yes

Enumerated

2007-01-11

Last updated

2007-07-08