| Doctor Name: | DR. JOHN JACKSON |
| NPI Number: | 1851541601 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DMD |
| License Number: | DI16549 |
| Business Practice Address: | 82 E Allendale Rd Suite 1b Saddle River, NJ - 074583057 |
| Business Phone Number: | 2017600994 |
| Business Fax Number: | 2017600996 |
| Mailing Address: | 82 E Allendale Rd, Suite 1b SADDLE RIVER |
| State: | NJ |
| Postal Code: | 074583057 |
| Phone Number: | 2017600994 |
| Fax Number: | 2017600996 |
| NPI Enumeration Date: | 09/29/2008 |
| NPI Last Update Date: | 09/29/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1223P0700X |
| License Number: | DI16549 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Dental Providers |
| Taxonomy Classification: | Dentist |
| Taxonomy Specialization: | Prosthodontics |
| Taxonomy Definition: | That branch of dentistry pertaining to the restoration and maintenance of oral functions, comfort, appearance and health of the patient by the restoration of natural teeth and/or the replacement of missing teeth and contiguous oral and maxillofacial tissues with artificial substitutes. |