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Organization
RALPH L. JACKSON, DDS, PC
Active
Organization
RALPH L. JACKSON, DDS, PC
Active
Other names
Cornelia Dental
Organization subpart
No
Provider details
NPI number
Authorized official
RALPH L JACKSON DDS (CEO)
(706) 778-8645
Entity
Organization
Contact information
Practice address
105 HIGHLAND AVE, CORNELIA, GA 30531-4366
(706) 778-8645
(706) 776-2650
Mailing address
105 HIGHLAND AVE, CORNELIA, GA 30531-4366
(706) 778-8645
(706) 776-2650
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
DN009940
GA
261QD0000X
Dental Clinic/Center
DN013723
GA
261QD0000X
Dental Clinic/Center
DN014968
GA
Other
Enumeration date
03/12/2009
Last updated
08/18/2017
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