Individual
DR. EDWARD MICHAEL JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
405 STATE ST, HACKENSACK, NJ 07601-4421
(201) 487-7030
(201) 487-4418
Mailing address
249 GREVE DR, NEW MILFORD, NJ 07646-2313
(201) 265-8879
(201) 487-4418
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
DI 21365
NJ
Other
Enumeration date
10/10/2006
Last updated
07/08/2007
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