NPI 1104119601

Jackson Dental LLC

Organisation General Practice Dentistry Layton, UT

Practice location

Address: 1868 N 400 W STE 110, Layton, UT 84041-2191
Phone: (801) 774-8198
Fax: (801) 774-8191

Authorised official

Name: Brett R Jackson
Title: Member
Phone: (801) 774-8198

Registered specialties

General Practice Dentistry Primary

Dental Providers Taxonomy 1223G0001X Licence 6593716-9922 (UT)

Other Dentist providers in Utah →

Registry record

NPI: 1104119601
Entity type: Organization
NPI issued: 17 May 2011
Record last updated: 17 May 2011

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.