STACY JACKSON, DDS
Dentist - Pediatric Dentistry
Active
Individual
NPI: 1043530991
Specialties
| Specialty | Code | Primary | License |
|---|---|---|---|
| Dentist | 122300000X | No | 2010016174 (MO) |
| Dentist - Pediatric Dentistry | 1223P0221X | Yes | DEN.00202791 (CO) |
Frequently Asked Questions
NPI 1043530991 is the National Provider Identifier for STACY JACKSON, DDS, a Dentist - Pediatric Dentistry provider located in Boulder, CO. This NPI was enumerated on June 2, 2010.
STACY JACKSON, DDS practices at 3400 PENROSE PL STE 107, Boulder, CO 80301.
Quick Facts
- NPI
- 1043530991
- Type
- Individual
- Enumerated
- Jun 2, 2010
- Last Updated
- Apr 26, 2023
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