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NPI Profile for LOUIS JACKSON III in ALBUQUERQUE, NM.
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Pediatric Dentistry |
1223P0221X |
| NPI # | 1285040337 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 07/09/2014 | |
| Last updated | 08/15/2024 - More than a year ago | |
| Sole proprietor 1 | No | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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LOUIS JACKSON III
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LOUIS JACKSON III