GREGORY WAYNE JACKSON

CHICAGO, IL
NPI1801970769
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics
(Licence: IL  019-014876)
Enumeration Date2006-10-25
Last Update Date2007-07-08
Business Address
Dr. GREGORY WAYNE JACKSON DDS
6435 S PULASKI RD
CHICAGO, IL 60629-5148
Phone number: 773-767-0849
Mailing Address
Dr. GREGORY WAYNE JACKSON DDS
6435 S PULASKI RD
CHICAGO, IL 60629-5148
Phone number: 773-767-0849
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