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Dr. Larry Tyler Jackson, DDS
Pediatric Dentist in Peoria, Arizona
NPI 1396186276

Larry Tyler Jackson is a Pediatric Dentist based in Peoria, AZ and is specialized in Pediatric Dentistry. Larry Tyler Jackson practices in Peoria, AZ and has the professional credentials of DDS. The NPI Number for Larry Tyler Jackson is 1396186276 and holds a License No. D009113 (Arizona).

The current practice location address for Larry Tyler Jackson is 14100 N 83Rd Ave, Peoria, AZ and can be reached out via phone at 623-935-9873.

Location: 14100 N 83Rd Ave, Peoria, AZ, 85381-5658
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1396186276
Provider Name
Larry Tyler Jackson
Credential
DDS
Provider Entity Type
Individual
Gender
Male
Address
14100 N 83Rd Ave, Peoria, AZ, 85381-5658
Phone Number
623-935-9873
Fax Number
Provider Enumeration Date
07/08/2013
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
14100 N 83Rd Ave
City
Peoria
State
Arizona
Zip
85381-5658
Phone Number
623-935-9873
Fax Number
person
Provider Business Mailing Address Details
Address
14100 N 83Rd Ave
City
Peoria
State
Arizona
Zip
85381-5658
Phone Number
623-935-9873
Fax Number
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Pediatric Dentistry
Taxonomy
1223P0221X
License No.
D009113 (Arizona)
Definition
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.
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