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Individual

MR. SEAN JACKSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RDH

Contact information

Practice address
111 W 7 MILE RD, DETROIT, MI 48203-1968
(313) 369-2600
(313) 369-2477
Mailing address
111 W 7 MILE RD, DETROIT, MI 48203-1968
(313) 369-2600
(313) 369-2477

Taxonomy

Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
2902014962
MI

Other

Enumeration date
07/10/2013
Last updated
07/10/2013
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