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Dr. Courtney Matthew Jackson, DDS
Pediatric Dentist in Rexburg, Idaho
NPI 1972864825

Courtney Matthew Jackson is a Pediatric Dentist based in Rexburg, ID and is specialized in Pediatric Dentistry. Courtney Matthew Jackson practices in Rexburg, ID and has the professional credentials of DDS. The NPI Number for Courtney Matthew Jackson is 1972864825 and holds a License No. 1433 (Idaho).

The current practice location address for Courtney Matthew Jackson is 859 S Yellowstone Hwy Ste 1202, Rexburg, ID and can be reached out via phone at 208-552-5439 and via fax at 208-552-5440.

Location: 859 S Yellowstone Hwy Ste 1202, Rexburg, ID, 83440-6201
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1972864825
Provider Name
Courtney Matthew Jackson
Credential
DDS
Provider Entity Type
Individual
Gender
Male
Address
859 S Yellowstone Hwy Ste 1202, Rexburg, ID, 83440-6201
Phone Number
208-552-5439
Fax Number
208-552-5440
Provider Enumeration Date
06/06/2012
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
859 S Yellowstone Hwy Ste 1202
City
Rexburg
State
Idaho
Zip
83440-6201
Phone Number
208-552-5439
Fax Number
208-552-5440
person
Provider Business Mailing Address Details
Address
859 S Yellowstone Hwy Ste 1202
City
Rexburg
State
Idaho
Zip
83440-6201
Phone Number
208-552-5439
Fax Number
208-552-5440
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Pediatric Dentistry
Taxonomy
1223P0221X
License No.
1433 (Wyoming)
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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