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Contact Information

NEALL C JACKSON, DDS
715 EAST ELDRIDGE AVENUE
WYNNE, AR72396-0368
 Phone: 870-238-3628
 Fax: 870-238-0757
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dentist

122300000X
Indicates primary specialty

NPI Profile & details for NEALL C JACKSON · (Male)

NPI # 1679699607
Status Active
Credentials DDS (Doctor of Dental Surgery)
Entity Individual
Enumeration date 03/21/2007
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 Yes
Identifiers
  • AR License # 3520
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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