Organization
BRANDI R. JACKSON DDS, MS, PLLC
Active
Other names
Northeast Pediatric Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRANDI R JACKSON DDS, MS (OWNER/DENTIST)
(704) 895-6445
Entity
Organization
Contact information
Practice address
11223 DAVINCI DR, DAVIDSON, NC 28036-7799
(704) 895-6445
(704) 895-6496
Mailing address
11223 DAVINCI DR, DAVIDSON, NC 28036-7799
(704) 895-6445
(704) 895-6496
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
8224
NC
Other
Enumeration date
08/31/2011
Last updated
08/31/2011
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