| NPI | 1144394545 |
|---|---|
| Former Legal Business Name | JOHN H JACKSON DDS PC |
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER J JACKSON President 605-892-6347 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: SD M525) |
| Additional Taxonomies | 122300000X Dentist (Licence: SD D0633) |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2010-11-03 |