Organization
MARLON B. JACKSON DDS,PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARLON BRADFORD JACKSON D.D.S., P.C. (OWNER)
(404) 681-3834
Entity
Organization
Contact information
Practice address
210 AUBURN AVE NE, SUITE 1, ATLANTA, GA 30303-2610
(404) 681-3834
(404) 681-9108
Mailing address
210 AUBURN AVE NE, SUITE 1, ATLANTA, GA 30303-2610
(404) 681-3834
(404) 681-9108
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
9878
GA
Other
Enumeration date
09/17/2008
Last updated
09/17/2008
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