Leonard Victor Jackson JR. D.D.S.

NPI 1154549715 - Dentist - 122300000X

NPI Details
NPI 1154549715
Gender Male
Enumeration Date 04/20/2007
Last Updated 01/28/2011
Entity Type Individual
Active Over 9 years ago
Practice Location
520 NORTH 12TH STREET
SUITE #406
RICHMOND VA, 23298-0566, US
Phone (804) 828-2977
Fax (804) 828-3159
Business Location
520 N. 12TH STREET
SUITE #406
RICHMOND VA, 23298-0566, US
Phone (804) 828-2977
Fax (804) 828-3159
Toxanomy
Taxonomy Code 122300000X
License State Virginia
License Number 0401411640
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According to our database, Mr. Leonard Victor Jackson JR. D.D.S. NPI is 1154549715, taxonomy code is 122300000X and license number is 0401411640, license state is located at Virginia. Leonard Victor Jackson JR. D.D.S. physically located at 520 North 12th Street, Richmond VA, 23298-0566. NPI Number Leonard Victor Jackson JR. D.D.S. has the Individual type.

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1154549715 NPI number is provided on an as is basis without warranty of any kind. 1154549715 is maintained by the National Plan & Provider Enumeration System. The contents of Leonard Victor Jackson JR. D.D.S. are for informational purposes only.