Jackson, Jennifer Marie

Jackson, Jennifer Marie is an individual health care provider with primary practice located at 819 Bloomington Rd , Champaign IL 61820-2101. She recently has only one registered license in Dental Providers / Dental Hygienist, which is considered as her primary health care specialty. Jackson, Jennifer Marie can be contacted via phone (217) 403-5477.

Contact Information

Primary practice address
819 Bloomington Rd Champaign IL 61820-2101
Phone: (217) 403-5477
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dental Hygienist 124Q00000X 020.015221 Illinois

Profile Details

NPI number 1831884931
LBN Legal business name Jackson, Jennifer Marie
Credentials Registered Dental Hygienist (RDH)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 6th, 2023
Last updated Apr 6th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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