Individual
DR. ADRIAN JACKSON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
111 WESTVIEW BLVD, SPARTANBURG, SC 29306-4132
(864) 515-6667
Mailing address
308 GRAYSON DR, MOORE, SC 29369-8919
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DGD.10796
SC
Other
Enumeration date
06/03/2024
Last updated
06/03/2024
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