Patricia Renee Jackson

NPI 1023377967 - Dentist - 122300000X

NPI Details
NPI 1023377967
Gender Female
Enumeration Date 05/13/2012
Last Updated 10/08/2013
Entity Type Individual
Active Over 4 years ago
Practice Location
191 HIGHWAY AND HOSPITAL ROAD
CHINLE AZ, 86503, US
Phone (928) 674-7166
Fax (928) 674-7705
Business Location
PO DRAWER PH
CHINLE AZ, 86503, US
Phone (928) 674-7166
Fax (928) 674-7705
Toxanomy
Taxonomy Code 122300000X
License State Ohio
License Number 30.023852
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According to our database, Miss Patricia Renee Jackson NPI is 1023377967, taxonomy code is 122300000X and license number is 30.023852, license state is located at Ohio. Patricia Renee Jackson physically located at 191 Highway And Hospital Road, Chinle AZ, 86503. NPI Number Patricia Renee Jackson has the Individual type.

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1023377967 NPI number is provided on an as is basis without warranty of any kind. 1023377967 is maintained by the National Plan & Provider Enumeration System. The contents of Patricia Renee Jackson are for informational purposes only.