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

TaxonomyCodeLicense
Dental Clinic/Center Primary 261QD0000XNone 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.