Organization
DENTAL EXPRESS-MIDDLEBURG HEIGHTS, BRIAN A JACKSON DDS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN E JACKSON DDS (OWNER)
(330) 533-3400
Entity
Organization
Contact information
Practice address
7043 PEARL RD, CLEVELAND, OH 44130-4973
(440) 845-7900
(440) 845-7969
Mailing address
3800 BOARDMAN CANFIELD RD, CANFIELD, OH 44406-9029
(330) 533-3400
(330) 533-2700
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
022150
OH
122300000X
Dentist
14383
OH
122300000X
Dentist
Primary
19620
OH
122300000X
Dentist
30-016841
OH
122300000X
Dentist
30-023233
OH
Other
Enumeration date
05/18/2010
Last updated
07/21/2010
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