Individual provider · Type 1 NPI
Charles B. Jackson, Jr., DDS, MSD
Orthodontics and Dentofacial Orthopedics Dentistry · Sandy, UT
Practice location
669 Union Sq
Sandy, UT 84070-3404
Fax (801) 571-9738
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry Primary | 1223X0400X | 142729-9921 (UT) |
Orthodontics and Dentofacial Orthopedics Dentistry: That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of funct…
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About NPI 1972563690
Charles B. Jackson, Jr., DDS, MSD's National Provider Identifier is 1972563690, issued on Mar 25, 2006. The primary taxonomy on file is Orthodontics and Dentofacial Orthopedics Dentistry (1223X0400X), and the practice location is in Sandy, UT. The record was last updated on Jul 13, 2026.