Organization
EARL W JACKSON DDS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EARL WAYNE JACKSON DDS (DENTIST)
(765) 674-7935
Entity
Organization
Contact information
Practice address
3802 S ADAMS ST, MARION, IN 46953
(765) 674-7935
(765) 677-1160
Mailing address
3802 S ADAMS ST, MARION, IN 46953
(765) 674-7935
(765) 677-1160
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5913
IN
Other
Enumeration date
06/28/2006
Last updated
09/18/2007
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