Timothy Michael Jackson DMD

NPI 1972610947 - Dentist - 122300000X

NPI Details
NPI 1972610947
Gender Male
Enumeration Date 08/24/2006
Last Updated 07/08/2007
Entity Type Individual
Active Over 10 years ago
Practice Location
ELBA AL, 36323, US
Phone (334) 897-3418
Fax (334) 897-3438
Business Location
PO BOX 450
ELBA AL, 36323, US
Phone (334) 897-3418
Fax (334) 897-3438
Taxonomy Code 122300000X
License State Alabama
License Number 4025
Remove 1972610947 NPI Number

According to our database, Timothy Michael Jackson DMD NPI is 1972610947, taxonomy code is 122300000X and license number is 4025, license state is located at Alabama. Timothy Michael Jackson DMD physically located at 982 Drayton Avenue, Elba AL, 36323. NPI Number Timothy Michael Jackson DMD has the Individual type.

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1972610947 NPI number is provided on an as is basis without warranty of any kind. 1972610947 is maintained by the National Plan & Provider Enumeration System. The contents of Timothy Michael Jackson DMD are for informational purposes only.