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Individual

DR. LLOYD JACKSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
2100 E LAKE COOK RD, SUITE 1100, BUFFALO GROVE, IL 60089-1999
(847) 580-5954
Mailing address
2100 E LAKE COOK RD, SUITE 1100, BUFFALO GROVE, IL 60089-1999
(847) 580-5954
(877) 821-6402

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12005914A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100133890
IN
Enumeration date
02/26/2007
Last updated
08/21/2012
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