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Contact Information

LLOYD B JACKSON, DMD
2700 FARMINGTON AVE
C -1
FARMINGTON, NM87401-4559
 Phone: 505-327-0044
 Fax: 505-325-0817
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dentist

122300000X
Indicates primary specialty

NPI Profile & details for LLOYD B JACKSON · (Male)

NPI # 1487785911
Status Active
Credentials DMD (Doctor of Medical Dentistry)
Entity Individual
Enumeration date 03/08/2007
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 Yes
Identifiers
  • NM License # DD2248
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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