| Jackson Clover Orthodontics Llc | |
|
1474 Highway 55 E Ste 100 Clover SC 29710-9218 | |
| (803) 653-6979 | |
| Not Available |
| Full Name | Jackson Clover Orthodontics Llc |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 1474 Highway 55 E Ste 100, Clover, South Carolina |
| Authorized Official Name and Position | Alfred Manwuel Jackson (OWNER) |
| Authorized Official Contact | 3522568164 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jackson Clover Orthodontics Llc 1474 Highway 55 E Ste 100 Clover SC 29710-9218 Ph: () - | Jackson Clover Orthodontics Llc 1474 Highway 55 E Ste 100 Clover SC 29710-9218 Ph: (803) 653-6979 |
| NPI Number | 1154187565 |
|---|---|
| Provider Enumeration Date | 02/23/2024 |
| Last Update Date | 02/23/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154187565 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | (* (Not Available)) | Primary |
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