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1801898648
MICHAEL D JACKSON
LAWTON, OK
NPI
1801898648
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: OK OK4831)
Enumeration Date
2005-08-11
Last Update Date
2007-07-08
Business Address
Dr. MICHAEL D JACKSON D.D.S
309 N. SHERIDAN RD
LAWTON, OK 73505
Phone number: 580-357-7878
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Mailing Address
Dr. MICHAEL D JACKSON D.D.S
910 NW MICKLEGATE BLVD
LAWTON, OK 73505-4134
Phone number: 580-536-1219
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