Carol D Jackson, D.D.S

NPI #1649496910 in Danville, Illinois

Provider Information

NPI Number: 1649496910
Entity Type: Individual
Name: Carol D Jackson, D.D.S
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dentist
Credential: D.D.S
Enumeration Date: Apr 17, 2007
Last Updated: Sep 19, 2012

Practice Location

Address: 614 N GILBERT ST
City: Danville
State: Illinois
ZIP Code: 61832-3940
Phone: (217) 442-8790

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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