Dr. Paul S. Jackson, D.M.D.
Student in an Organized Health Care Education/Training Program in Salt Lake City, UT. Individual provider (NPI-1).
NPI number1467688564
StatusActive
Last updated in NPPESJun 3, 2009
Details
- NPI
- 1467688564
- Entity type
- Individual (NPI-1)
- Name
- Dr. Paul S. Jackson
- Credential
- D.M.D.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jun 3, 2009
- Last updated
- Jun 3, 2009
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – | Yes |
Practice location
26 South 200 EastSuite 5900
Salt Lake City, UT 84112
Phone 801-585-6485
Mailing address
4237 Cumberland RdHolladay, UT 84124-2737
Phone 801-671-6228
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