Individual
DR. DEXTER E JACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM.D
Contact information
Practice address
2500 DALLAS HWY SW, SUITE 300, MARIETTA, GA 30064-2567
(770) 426-3256
Mailing address
2500 DALLAS HWY SW, SUITE 300, MARIETTA, GA 30064-2567
(770) 426-3256
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH024007
GA
Other
Enumeration date
01/12/2013
Last updated
01/12/2013
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