| Dr Richard K Jackson Pa | |
|
326 W Boynton Beach Blvd Boynton Beach FL 33435-4025 | |
| (561) 737-6445 | |
| (561) 737-1524 |
| Full Name | Dr Richard K Jackson Pa |
|---|---|
| Speciality | Dentist |
| Location | 326 W Boynton Beach Blvd, Boynton Beach, Florida |
| Authorized Official Name and Position | Richard K Jackson (DENTIST) |
| Authorized Official Contact | 5617376445 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Richard K Jackson Pa 326 W Boynton Beach Blvd Boynton Beach FL 33435-4025 Ph: (561) 737-6445 | Dr Richard K Jackson Pa 326 W Boynton Beach Blvd Boynton Beach FL 33435-4025 Ph: (561) 737-6445 |
| NPI Number | 1407127640 |
|---|---|
| Provider Enumeration Date | 01/19/2012 |
| Last Update Date | 01/19/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407127640 | NPI | - | NPPES |
| 073772100 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DN12332 (Florida) | Primary |
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