Individual
DR. CARL DENNIS JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
3200 CONCORD RD, SUITE 200, ASTON, PA 19014-1931
(610) 872-7461
(610) 494-7559
Mailing address
188 WOODLARK LN, GLEN RIDDLE, PA 19063-5706
(610) 358-0369
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS018783L
PA
Other
Enumeration date
05/09/2007
Last updated
12/07/2012
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