Individual
HENRY JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
55 GLENDA TRCE, NEWNAN, GA 30265-3887
(770) 252-4466
Mailing address
106 W COVE DR, NEWNAN, GA 30263-6370
(678) 877-5423
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN015907
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DN015907
GENERAL PRACTICE
GA
Enumeration date
07/25/2019
Last updated
07/25/2019
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us