| Daniel Jackson Dds Pc | |
|
821 West Pine Blvd Poplar Bluff MO 63901-4956 | |
| (573) 785-6434 | |
| (573) 785-6435 |
| Full Name | Daniel Jackson Dds Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 821 West Pine Blvd, Poplar Bluff, Missouri |
| Authorized Official Name and Position | Daniel Jackson (CORPORATE PRESIDENT) |
| Authorized Official Contact | 5737856434 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Daniel Jackson Dds Pc 821 West Pine Blvd Poplar Bluff MO 63901-4956 Ph: (573) 785-6434 | Daniel Jackson Dds Pc 821 West Pine Blvd Poplar Bluff MO 63901-4956 Ph: (573) 785-6434 |
| NPI Number | 1225205362 |
|---|---|
| Provider Enumeration Date | 05/08/2008 |
| Last Update Date | 05/08/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225205362 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 14158 (Missouri) | Primary |
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