Organization · Type 2 NPI
Leroy R Jackson JR DDS PLLC
Dental Clinic/Center · Ranson, WV
NPI number
1497010136
Active
Practice location
215 E 5th Ave
Ranson, WV 25438-1613
Fax (304) 728-7519
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dental Clinic/Center Primary | 261QD0000X | None listed |
Dental Clinic/Center: Definition to come...
2 other providers at this address
About NPI 1497010136
Leroy R Jackson JR DDS PLLC's National Provider Identifier is 1497010136, issued on Jul 9, 2012. The primary taxonomy on file is Dental Clinic/Center (261QD0000X), and the practice location is in Ranson, WV. The record was last updated on Jul 9, 2012.