Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. RICHARD M JACKSON JR., DDS
ActiveDR. RICHARD M JACKSON JR., DDS is a General Dentistry healthcare provider located in PORTER, Oklahoma. NPI 1801123633 is currently active in the NPPES registry. Verify at CMS.
General Dentistry · PORTER, OK
Registration Details
- NPI Number
- 1801123633
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Nov 16, 2009 (16.758675189794 yrs)
- Last Updated
- Jan 5, 2012
- License
-
5920 (OK)
Practice Information
- Address
-
505 S MAINPORTER, OK, 74454Browse OK providers · Browse ZIP 74454
- Phone
- 9184830012
- Fax
- 9184834174
- Primary Specialty
-
General Dentistry
1223G0001X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.