NPI 1023359510

Marylyn Jackson

Practitioner General Practice Dentistry Olympia Fields, IL

Practice location

Address: 2555 Lincoln Hwy Suite 113, Olympia Fields, IL 60461-1936
Phone: (708) 679-0668

Registered specialties (2)

General Practice Dentistry Primary

Dental Providers Taxonomy 1223G0001X Licence 019-017207 (IL)

Other Dentist providers in Illinois →

Dentist

Dental Providers Taxonomy 122300000X Licence 019-017207 (IL)

Registry record

NPI: 1023359510
Entity type: Individual
Sex (as registered): Female
NPI issued: 7 Mar 2013
Record last updated: 7 Mar 2013

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.