Individual
DR. ELIZABETH OSBORNE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
317 ROSEWOOD ST, IRONDALE, AL 35210-3116
(205) 956-2869
Mailing address
317 ROSEWOOD ST, IRONDALE, AL 35210-3116
(205) 956-2869
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5564
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5564
UNIVERSITY OF ALABAMA IN
AL
Enumeration date
07/11/2007
Last updated
10/04/2010
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