| Jackson Dental Prof. Llc | |
|
503 Jackson St Belle Fourche SD 57717 | |
| (605) 892-6347 | |
| (605) 892-9027 |
| Full Name | Jackson Dental Prof. Llc |
|---|---|
| Speciality | Dentist |
| Location | 503 Jackson St, Belle Fourche, South Dakota |
| Authorized Official Name and Position | Christopher J Jackson (PRESIDENT) |
| Authorized Official Contact | 6058926347 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jackson Dental Prof. Llc 503 Jackson St Belle Fourche SD 57717 Ph: (605) 892-6347 | Jackson Dental Prof. Llc 503 Jackson St Belle Fourche SD 57717 Ph: (605) 892-6347 |
| NPI Number | 1144394545 |
|---|---|
| Provider Enumeration Date | 11/17/2006 |
| Last Update Date | 11/03/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144394545 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | D0633 (South Dakota) | Secondary |
| 122300000X | Dentist | M525 (South Dakota) | Primary |
Nehl Dental, Inc. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 605 Railroad St, Belle Fourche, SD 57717 Phone: 605-892-3603 |