Bruce W Jackson is a Dentist in Liberal, Kansas. Bruce W Jackson practices all healthcare services and medical treatments related to Dentist. The NPI Number for Bruce W Jackson is 1851430532. The last update date is 2007-07-08.
Bruce W Jackson's current location address is 111 Lilac Dr, Liberal, Kansas. You can contact this provider via phone number 6206240196 and fax number 6206242443. The mailing address for Bruce W Jackson is 111 Lilac Dr, Liberal, Kansas. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Bruce W Jackson |
|---|---|
| Address | 111 Lilac Dr, Liberal, Kansas |
| Phone Number | 6206240196 |
| Fax Number | 6206242443 |
| Sole Proprietor | N |
| Credentials | DDS |
NPI Number Detail
| NPI Number | 1851430532 |
|---|---|
| Provider Enumeration Date | 2007-02-06 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 111 Lilac Dr |
|---|---|
| City | Liberal |
| State | Kansas (KS) |
| Post Code | 67901 |
| Phone Number | 6206240196 |
| Fax Number | 6206242443 |
Provider's Primary Taxonomy Detail
| Speciality | Dentist |
|---|---|
| Taxonomy | 122300000X |
| Licence No | 5376 |
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Definition: A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: denti |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 5376 | KS | KANSAS DENTAL BOARD |
Post Comment/ Review Below
What is the unique 10-digit identifier code assigned to Bruce W Jackson by the Centers for Medicare & Medicaid Services?
The Bruce W Jackson has been issued the NPI (National Provider Identifier) 1851430532 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Could you kindly provide the complete physical address where Bruce W Jackson's facilities are geographically located?
The facilities of Bruce W Jackson are physically situated at the following location: 111 Lilac Dr, Liberal, KS, 67901.
What is Bruce W Jackson's specialized field of practice, and what is the corresponding taxonomy classification code?
The Bruce W Jackson's area of specialization is Dentist, and the corresponding taxonomy code that categorizes this field of practice is 122300000X.
On what date did the Bruce W Jackson receive its 1851430532 assignment from the Centers for Medicare & Medicaid Services?
The Bruce W Jackson was assigned its 1851430532 by the Centers for Medicare & Medicaid Services on 2007-02-06.
When was the information pertaining to Bruce W Jackson most recently updated or revised?
The details related to Bruce W Jackson, including its address, specialty, and other relevant information, were last updated or revised on 2007-07-08.
NPI Number: 1215930425
Address: 224 W Exchange St, Akron, OH