Individual provider · Type 1 NPI

Paul S. Jackson, DMD

Student in an Organized Health Care Education/Training Program · Salt Lake City, UT

NPI number 1467688564 Active

Practice location

26 South 200 East, Suite 5900
Salt Lake City, UT 84112

Call (801) 585-6485 Map

Mailing address

4237 Cumberland Rd
Holladay, UT 84124-2737

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1467688564

Paul S. Jackson, DMD's National Provider Identifier is 1467688564, issued on Jun 3, 2009. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Salt Lake City, UT. The record was last updated on Jun 3, 2009.