| Gregory W. Jackson Dds, Ltd | |
|
6435 S Pulaski Rd Chicago IL 60629-5148 | |
| (773) 767-0849 | |
| (773) 767-0861 |
| Full Name | Gregory W. Jackson Dds, Ltd |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 6435 S Pulaski Rd, Chicago, Illinois |
| Authorized Official Name and Position | Gregory Wayne Jackson (PRESIDENT) |
| Authorized Official Contact | 7737670849 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gregory W. Jackson Dds, Ltd 6435 S Pulaski Rd Chicago IL 60629-5148 Ph: (773) 767-0849 | Gregory W. Jackson Dds, Ltd 6435 S Pulaski Rd Chicago IL 60629-5148 Ph: (773) 767-0849 |
| NPI Number | 1205911120 |
|---|---|
| Provider Enumeration Date | 10/26/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205911120 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (Illinois) | Primary |
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