Daniel Jackson DDS PC

General Practice Dentistry · Poplar Bluff, MO

Organization Active NPI

NPI number 1225205362

Practice location

821 West Pine Blvd
Poplar Bluff, MO 63901-4956
Phone
(573) 785-6434
Fax
(573) 785-6435

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NPI record

NPI
1225205362
Entity type
Organization (Type 2)
Enumeration date
May 8, 2008
Last updated
May 8, 2008
Organization subpart
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
General Practice Dentistry Primary 1223G0001X 14158 MO

Authorized official

Name
Dr. Daniel Jackson, DDS
Title
Corporate President
Phone
(573) 785-6434

About Daniel Jackson DDS PC

Daniel Jackson DDS PC is a healthcare organization registered in the NPI registry with the primary taxonomy General Practice Dentistry (code 1223G0001X). The practice location is 821 West Pine Blvd, Poplar Bluff, MO 63901-4956. The NPI number 1225205362 was assigned on May 8, 2008 and the record was last updated on May 8, 2008.

Daniel Jackson DDS PC lists a license in the registry: #14158 (MO) for General Practice Dentistry. License numbers are self-reported to NPPES; verify them with the state licensing board.

The authorized official for this organization is Dr. Daniel Jackson, DDS, Corporate President.

Frequently asked questions

What is the NPI number of Daniel Jackson DDS PC?

The NPI number is 1225205362.

What is the phone number of Daniel Jackson DDS PC?

The phone number listed for the practice location is (573) 785-6434.

Where is Daniel Jackson DDS PC located?

821 West Pine Blvd, Poplar Bluff, MO 63901-4956.

What is the taxonomy code for Daniel Jackson DDS PC?

The primary taxonomy code is 1223G0001X – General Practice Dentistry.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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