Organization
BRIAN E JACKSON DDS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN E JACKSON (OWNER)
(440) 944-7775
Entity
Organization
Contact information
Practice address
2775 BISHOP RD, SUITE C, WILLOUGHBY HILLS, OH 44092-2683
(440) 944-7775
Mailing address
2775 BISHOP RD, SUITE C, WILLOUGHBY HILLS, OH 44092-2683
(440) 944-7775
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
08/03/2016
Last updated
08/09/2016
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