Individual provider · Type 1 NPI
Courtney Matthew Jackson, DDS
Pediatric Dentistry · Rexburg, ID
NPI number
1972864825
Active
Practice location
859 S Yellowstone Hwy Ste 1202
Rexburg, ID 83440-6201
Fax (208) 552-5440
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pediatric Dentistry | 1223P0221X | 1433 (WY) |
| Pediatric Dentistry Primary | 1223P0221X | D-4655-PD (ID) |
Pediatric Dentistry: An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
Another provider at this address
Other pediatric dentistry providers in Rexburg
About NPI 1972864825
Courtney Matthew Jackson, DDS's National Provider Identifier is 1972864825, issued on Jun 6, 2012. The primary taxonomy on file is Pediatric Dentistry (1223P0221X), and the practice location is in Rexburg, ID. The record was last updated on Feb 3, 2016.