CAROL D JACKSON

DANVILLE, IL
NPI1649496910
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy122300000X Dentist
(Licence: MD  14764)
Additional Taxonomies122300000X Dentist
(Licence: IL  019023180)
Enumeration Date2007-04-17
Last Update Date2012-09-19
Business Address
-- CAROL D JACKSON D.D.S
614 N GILBERT ST
DANVILLE, IL 61832-3940
Phone number: 217-442-8790
Mailing Address
-- CAROL D JACKSON D.D.S
208 CRAIN HIGHWAY, SOUTHWEST
GLEN BURNIE, MD 21061
Phone number: 310-498-0002