Organization
BRIAN E JACKSON DDS LLC
Active
Parent organization
BRIAN E JACKSON DDS LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
BRIAN E JACKSON DDS LLC
Authorized official
DR. BRIAN EDWARD JACKSON DDS (OWNER)
(440) 944-7775
Entity
Organization
Contact information
Practice address
2775 BISHOP RD STE C, WILLOUGHBY HILLS, OH 44092-2683
(440) 944-7775
(440) 944-7887
Mailing address
2775 BISHOP RD STE C, WILLOUGHBY HILLS, OH 44092-2683
(440) 944-7775
(440) 944-7887
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
04/25/2019
Last updated
04/25/2019
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