Individual
DR. EDDIE C. JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1300 HIGHWAY 231 S, TROY, AL 36081-3058
(334) 566-7600
(334) 566-9181
Mailing address
PO BOX 928, TROY, AL 36081-0928
(334) 566-7600
(334) 566-9181
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5377
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
136342
—
AL
Enumeration date
08/31/2006
Last updated
06/19/2012
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