Organization
STATE STREET-ORTHODONTICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDWARD MICHAEL JACKSON DMD (OWNER)
(201) 487-7030
Entity
Organization
Contact information
Practice address
405 MAIN ST, HACKENSACK, NJ 07601-5965
(201) 487-7030
(201) 487-4418
Mailing address
405 MAIN ST, HACKENSACK, NJ 07601-5965
(201) 487-7030
(201) 487-4418
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
02/27/2026
Last updated
02/27/2026
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