Organization
CLARK AND JACKSON PD, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHANIE JACKSON (OWNER)
(803) 548-2333
Entity
Organization
Contact information
Practice address
1690 HIGHWAY 160 W STE A, FORT MILL, SC 29708-8024
(803) 548-2333
Mailing address
1690 HIGHWAY 160 W STE A, FORT MILL, SC 29708-8024
(803) 548-2333
(803) 324-4128
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
11/02/2020
Last updated
11/24/2020
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