Individual
DR. MICHAEL J JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
4701 BAPTIST RD, SUITE 100, PITTSBURGH, PA 15227-1117
(412) 884-7757
Mailing address
609 BROUGHTON RD, BETHEL PARK, PA 15102-3730
(412) 833-5982
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS020084L
PA
Other
Enumeration date
04/25/2007
Last updated
07/08/2007
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