# JACKSON FAMILY DENTISTRY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1326250325
- **Authorized official:** DR. CARL JACKSON JR. DDS (OWNER)
- **Authorized official phone:** (765) 284-7242

## Contact information

- **Practice address:** 202 RESERVE, MUNCIE, IN 47303
- **Practice address phone:** (765) 284-7242
- **Practice address fax:** (765) 289-8331
- **Mailing address:** 202 RESERVE, MUNCIE, IN 47303
- **Mailing address phone:** (765) 284-7242
- **Mailing address fax:** (765) 289-8331

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 12010844A | IN | Yes |

## Other

- **Enumeration date:** 05/04/2007
- **Last updated:** 08/22/2020