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1023377967
PATRICIA RENEE JACKSON
CHINLE, AZ
NPI
1023377967
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
122300000X Dentist
(Licence: OH 30.023852)
Enumeration Date
2012-05-13
Last Update Date
2013-10-08
Business Address
Miss PATRICIA RENEE JACKSON
191 HIGHWAY AND HOSPITAL ROAD
CHINLE, AZ 86503
Phone number: 928-674-7166
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Mailing Address
Miss PATRICIA RENEE JACKSON
PO DRAWER PH
CHINLE, AZ 86503
Phone number: 928-674-7166
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