Individual
DR. JONATHAN MICHAEL JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
755 MOUNT VERNON HWY NE, SUITE 100, ATLANTA, GA 30328-4274
(404) 255-8443
(404) 255-1326
Mailing address
755 MOUNT VERNON HWY NE, SUITE 100, ATLANTA, GA 30328-4274
(404) 255-8443
(404) 255-1326
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
DN011776
GA
Other
Enumeration date
01/23/2007
Last updated
07/08/2007
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