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1619538436
RYNE JACKSON
LAKE CHARLES, LA
NPI
1619538436
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
122300000X Dentist
(Licence: LA 7005)
Enumeration Date
2019-06-24
Last Update Date
2019-06-24
Business Address
RYNE JACKSON DMD
2629 COUNTRY CLUB RD
LAKE CHARLES, LA 70605-5911
Phone number: 337-474-3636
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Mailing Address
RYNE JACKSON DMD
5225 ELLIOTT RD APT 517
LAKE CHARLES, LA 70605-5809
Phone number:
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