Jackson, Charles Russell

Jackson, Charles Russell is an individual health care provider with primary practice located at 1 Med Center Dirve , Morgantown WV 26506. He recently has only one registered license in Dental Providers / Endodontics, which is considered as his primary health care specialty. Jackson, Charles Russell can be contacted via phone (304) 293-2240.

Contact Information

Primary practice address
1 Med Center Dirve Morgantown WV 26506
Phone: (304) 293-2240
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Endodontics 1223E0200X 2122 West Virginia

Profile Details

NPI number 1306929856
LBN Legal business name Jackson, Charles Russell
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 20th, 2006
Last updated Jul 8th, 2007 - about 17 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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