MISS Patricia Renee Jackson

NPI #1023377967 in Chinle, Arizona

Provider Information

NPI Number: 1023377967
Entity Type: Individual
Name: MISS Patricia Renee Jackson
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist
Enumeration Date: May 13, 2012
Last Updated: Oct 8, 2013

Practice Location

Address: 191 HIGHWAY AND HOSPITAL ROAD
City: Chinle
State: Arizona
ZIP Code: 86503
Phone: (928) 674-7166

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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