Jonathan Brian Jackson DDS

NPI 1659659621 - Dentist - 1223G0001X

NPI Details
NPI 1659659621
Gender Male
Enumeration Date 07/25/2011
Last Updated 07/25/2011
Entity Type Individual
Active Over 5 years ago
Practice Location
422 1/2 VIOLET AVE
MONROVIA CA, 91016-6731, US
Phone (951) 551-8686
Fax
Business Location
422 1/2 VIOLET AVE
MONROVIA CA, 91016-6731, US
Phone (951) 551-8686
Fax
Toxanomy
Taxonomy Code 1223G0001X
License State California
License Number 60538
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According to our database, Dr. Jonathan Brian Jackson DDS NPI is 1659659621, taxonomy code is 1223G0001X and license number is 60538, license state is located at California. Jonathan Brian Jackson DDS physically located at 422 1/2 Violet Ave, Monrovia CA, 91016-6731. NPI Number Jonathan Brian Jackson DDS has the Individual type.

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1659659621 NPI number is provided on an as is basis without warranty of any kind. 1659659621 is maintained by the National Plan & Provider Enumeration System. The contents of Jonathan Brian Jackson DDS are for informational purposes only.