CHARLES RUSSELL JACKSON

MORGANTOWN, WV
NPI1306929856
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1223E0200X Dentist, Endodontics
(Licence: WV  2122)
Enumeration Date2006-10-20
Last Update Date2007-07-08
Business Address
-- CHARLES RUSSELL JACKSON DDS
1 MED CENTER DIRVE
MORGANTOWN, WV 26506
Phone number: 304-293-2240
Mailing Address
-- CHARLES RUSSELL JACKSON DDS
1 MED CENTER DIRVE
MORGANTOWN, WV 26506
Phone number: 304-293-2240
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