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Contact Information

NATALIE A JACKSON
2603 W PLEASANT GROVE RD STE 111
ROGERS, AR72758-8514
 Phone: 479-282-1023
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dentist

122300000X
Indicates primary specialty

NPI Profile & details for NATALIE A JACKSON · (Female)

NPI # 1104513134
Status Active
Credentials
Entity Individual
Enumeration date 04/19/2023
Last updated 04/04/2024 - About 2 years ago
Sole proprietor 1 Yes
Identifiers
  • AR License # 4722
  • MO License # 2023022968
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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