Booth, Jackson Robert

Booth, Jackson Robert is an individual health care provider with primary practice located at 4410 E Riverside Dr Suite 150, Austin TX 78741-4799. He recently has 2 registered licenses in different health care specialties including Dental Providers / General Practice, Dental Providers / Dentist. Dental Providers / General Practice is his primary health care specialty. Booth, Jackson Robert can be contacted via phone (512) 739-9440.

Contact Information

Primary practice address
4410 E Riverside Dr Suite 150 Austin TX 78741-4799
Phone: (512) 739-9440
Fax: (512) 389-9797
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 23496 Texas
Dental Providers / Dentist 122300000X D9554 Oregon

Profile Details

NPI number 1891987368
LBN Legal business name Booth, Jackson Robert
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 17th, 2007
Last updated Feb 18th, 2014 - about 10 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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