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Contact Information

DENNIS W JACKSON, DDS
164 SQUARE H RD
EDGEWOOD, NM87015-9538
 Phone: 505-610-7885
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dentist

122300000X
Indicates primary specialty

NPI Profile & details for DENNIS W JACKSON · (Male)

NPI # 1881999761
Status Active
Credentials DDS (Doctor of Dental Surgery)
Entity Individual
Enumeration date 01/24/2011
Last updated 01/24/2011 - About 15 years ago
Sole proprietor 1 Yes
Identifiers
  • NM License # DD2699
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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