Van, Jackson
Van, Jackson is an sole proprietor health care provider with primary practice located at 20140 Mcloughlin Blvd , Gladstone OR 97027-2604. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Van, Jackson can be contacted via phone (971) 404-1374.Contact Information
Primary practice address
20140 Mcloughlin Blvd
Gladstone OR 97027-2604
Phone: (971) 404-1374
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | D12050 | Oregon |
Profile Details
| NPI number | 1083442164 |
|---|---|
| LBN Legal business name | Van, Jackson |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 22nd, 2024 |
| Last updated | Nov 18th, 2024 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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