Michael Roy Jackson DDS

NPI 1083735369 - Dentist - 1223G0001X

NPI Details
NPI 1083735369
Gender Male
Enumeration Date 04/03/2007
Last Updated 07/08/2007
Entity Type Individual
Active Over 9 years ago
Practice Location
6924 SOUTH FWY
FT WORTH TX, 76134-3800, US
Phone (817) 293-7431
Fax (817) 293-3848
Business Location
6924 SOUTH FWY
FT WORTH TX, 76134-3800, US
Phone (817) 293-7431
Fax (817) 293-3848
Toxanomy
Taxonomy Code 1223G0001X
License State Texas
License Number 11498
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According to our database, Dr. Michael Roy Jackson DDS NPI is 1083735369, taxonomy code is 1223G0001X and license number is 11498, license state is located at Texas. Michael Roy Jackson DDS physically located at 6924 South Fwy, Ft Worth TX, 76134-3800. NPI Number Michael Roy Jackson DDS has the Individual type.

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1083735369 NPI number is provided on an as is basis without warranty of any kind. 1083735369 is maintained by the National Plan & Provider Enumeration System. The contents of Michael Roy Jackson DDS are for informational purposes only.