Jackson Orthodontics | |
8250 Bryan Dairy Rd #325 Largo FL 33777-1353 | |
(727) 397-0353 | |
(727) 397-5773 |
Full Name | Jackson Orthodontics |
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Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
Location | 8250 Bryan Dairy Rd, Largo, Florida |
Authorized Official Name and Position | Joseph C. Jackson (ORTHODONTIST) |
Authorized Official Contact | 7273970353 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Jackson Orthodontics 8250 Bryan Dairy Rd #325 Largo FL 33777-1353 Ph: (727) 397-0353 | Jackson Orthodontics 8250 Bryan Dairy Rd #325 Largo FL 33777-1353 Ph: (727) 397-0353 |
NPI Number | 1710109756 |
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Provider Enumeration Date | 05/02/2007 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1710109756 | NPI | - | NPPES |
DN5413 | Other | FL | STATE LICENSE |
85760 | Other | FL | BCBS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | DN5413 (Florida) | Primary |
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