Individual
DR. ARLITA D JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
1790 MULKEY RD, BLDG 4, AUSTELL, GA 30106-1103
(770) 739-4400
(770) 739-9077
Mailing address
1790 MULKEY RD, STE4, AUSTELL, GA 30106-1122
(770) 739-4400
(770) 739-9077
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN11004
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00480213B
—
GA
Enumeration date
03/05/2007
Last updated
05/23/2012
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