| Jackson Dental, P.a. | |
|
101 E Kennedy Blvd Ste 300 Tampa FL 33602-5179 | |
| (352) 871-2577 | |
| Not Available |
| Full Name | Jackson Dental, P.a. |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 101 E Kennedy Blvd, Tampa, Florida |
| Authorized Official Name and Position | Geoffrey A Jackson (CEO/OWNER) |
| Authorized Official Contact | 3528712577 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jackson Dental, P.a. 101 E Kennedy Blvd Ste 300 Tampa FL 33602-5179 Ph: () - | Jackson Dental, P.a. 101 E Kennedy Blvd Ste 300 Tampa FL 33602-5179 Ph: (352) 871-2577 |
| NPI Number | 1588002620 |
|---|---|
| Provider Enumeration Date | 06/11/2013 |
| Last Update Date | 06/11/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588002620 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | DN18870 (Florida) | Primary |
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