Individual
CAMILLE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
2221 HAYES AVE, FREMONT, OH 43420-2632
(419) 334-3869
Mailing address
4434 CYGNET CT, GROVEPORT, OH 43125-5500
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
30.027948
OH
Other
Enumeration date
05/19/2025
Last updated
05/19/2025
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