Individual
ERIC JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
2033 OGDEN AVE, DOWNERS GROVE, IL 60515-2601
(630) 963-6750
(630) 963-6761
Mailing address
2033 OGDEN AVE, DOWNERS GROVE, IL 60515-2601
(630) 963-6750
(630) 963-6761
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019026703
IL
Other
Enumeration date
04/06/2007
Last updated
05/05/2009
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