Carol D Jackson, DDS | |
614 N Gilbert St, Danville, IL 61832-3940 | |
(217) 442-8790 | |
(217) 442-8780 |
Full Name | Carol D Jackson |
---|---|
Gender | Female |
Speciality | Dentist |
Location | 614 N Gilbert St, Danville, Illinois |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1649496910 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | 14764 (Maryland) | Primary |
122300000X | Dentist | 019023180 (Illinois) | Secondary |
Entity Name | Fetter Health Care Network Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1003827304 PECOS PAC ID: 9032215199 Enrollment ID: O20070507000192 |
Entity Name | Fetter Health Care Network Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1982124301 PECOS PAC ID: 9032215199 Enrollment ID: O20171228002000 |
Mailing Address | Practice Location Address |
---|---|
Carol D Jackson, DDS 208 Crain Highway, Southwest, Glen Burnie, MD 21061 Ph: (310) 498-0002 | Carol D Jackson, DDS 614 N Gilbert St, Danville, IL 61832-3940 Ph: (217) 442-8790 |
Dr. Karl Frank Muster, D.D.S. Dentist Medicare: Not Enrolled in Medicare Practice Location: 1010 N Gilbert St, Danville, IL 61832 Phone: 217-442-4878 Fax: 217-442-2148 | |
Mark W Anderson, DDS MS Dentist Medicare: Not Enrolled in Medicare Practice Location: 909 N Logan Ave, Danville, IL 61832 Phone: 217-446-8696 Fax: 217-446-1969 | |
Dr. Richard Mark Vanburk, D.M.D. Dentist Medicare: Not Enrolled in Medicare Practice Location: 610 N Logan Ave, Danville, IL 61832 Phone: 217-442-3385 Fax: 217-442-2517 | |
Dr. Donald Craig Tigchelaar, D.D.S. Dentist Medicare: Medicare Enrolled Practice Location: 1900 E Main St, Va Illiana Healthcare System, Danville, IL 61832 Phone: 217-554-4516 Fax: 217-554-4881 | |
Dr. James Matthew Hardy, D.D.S. Dentist Medicare: Medicare Enrolled Practice Location: 809 N Gilbert St, Danville, IL 61832 Phone: 217-442-3020 Fax: 217-442-3943 | |
Dr. Jacob S Froerer, DDS, MSD Dentist Medicare: Not Enrolled in Medicare Practice Location: 1900 E Main St, Danville, IL 61832 Phone: 217-554-3110 | |
Dr. Kevin King, DMD Dentist Medicare: Not Enrolled in Medicare Practice Location: 1010 N Gilbert St, Danville, IL 61832 Phone: 217-442-4878 |