Organization
JACKSON FAMILY DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CARL JACKSON JR. DDS (OWNER)
(765) 284-7242
Entity
Organization
Contact information
Practice address
202 RESERVE, MUNCIE, IN 47303
(765) 284-7242
(765) 289-8331
Mailing address
202 RESERVE, MUNCIE, IN 47303
(765) 284-7242
(765) 289-8331
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12010844A
IN
Other
Enumeration date
05/04/2007
Last updated
08/22/2020
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