Individual
DR. RICHARD EDWIN JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
109 TIMBERMILL DR, LEXINGTON, SC 29073-7138
(803) 957-2297
(803) 957-4178
Mailing address
109 TIMBERMILL DR, LEXINGTON, SC 29073-7138
(803) 957-2297
(803) 957-4178
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2037
SC
Other
Enumeration date
07/27/2006
Last updated
07/08/2007
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