Earl W Jackson DDS INC

NPI #1669409058 in Marion, Indiana

Provider Information

NPI Number: 1669409058
Entity Type: Organization
Organization Name: Earl W Jackson DDS INC
Primary Specialty: Dentist
Enumeration Date: Jun 28, 2006
Last Updated: Sep 18, 2007

Practice Location

Address: 3802 S ADAMS ST
City: Marion
State: Indiana
ZIP Code: 46953
Phone: (765) 674-7935

Authorized Official

Name: EARL WAYNE JACKSON, DDS
Title: DENTIST
Phone: (765) 674-7935

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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