MR. Bruce W Jackson, DDS

NPI #1851430532 in Liberal, Kansas

Provider Information

NPI Number: 1851430532
Entity Type: Individual
Name: MR. Bruce W Jackson, DDS
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist
Credential: DDS
Enumeration Date: Feb 6, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 111 LILAC DR
City: Liberal
State: Kansas
ZIP Code: 67901
Phone: (620) 624-0196

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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