| David P Jackson Dds, Pc | |
|
3393 Iris Ave Suite 103 Boulder CO 80301-5205 | |
| (303) 447-2872 | |
| (303) 447-2896 |
| Full Name | David P Jackson Dds, Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 3393 Iris Ave, Boulder, Colorado |
| Authorized Official Name and Position | David Paul Jackson (OWNER/DENTIST) |
| Authorized Official Contact | 3034472872 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| David P Jackson Dds, Pc 3393 Iris Ave Suite 103 Boulder CO 80301-5205 Ph: (303) 447-2872 | David P Jackson Dds, Pc 3393 Iris Ave Suite 103 Boulder CO 80301-5205 Ph: (303) 447-2872 |
| NPI Number | 1861893067 |
|---|---|
| Provider Enumeration Date | 09/08/2014 |
| Last Update Date | 09/08/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861893067 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 6979 (Colorado) | Primary |
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