DR. Mario Michael Jackson, D.D.S.

NPI #1144302811 in North Las Vegas, Nevada

Provider Information

NPI Number: 1144302811
Entity Type: Individual
Name: DR. Mario Michael Jackson, D.D.S.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist
Credential: D.D.S.
Enumeration Date: Oct 20, 2006
Last Updated: Jul 8, 2007

Practice Location

Address: 1013 HARP WAY
City: North Las Vegas
State: Nevada
ZIP Code: 89032-7889
Phone: (702) 505-3914

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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