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Individual

MRS. ANNABELLE M JACKSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
7101 HOFF ST # 9240, FORT BENNING, GA 31905-5645
(706) 544-2052
Mailing address
1186 OSSAHATCHIE CREEK RD, ELLERSLIE, GA 31807-5332
(706) 617-7913

Taxonomy

Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary

Other

Enumeration date
08/03/2021
Last updated
08/03/2021
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