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1718 N Coastal Hwy Midway GA 31320-3415 | |
(912) 880-2288 | |
(912) 880-2110 |
Full Name | |
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Speciality | Dentist - General Practice |
Location | 1718 N Coastal Hwy, Midway, Georgia |
Authorized Official Name and Position | Rollin B Jackson (OWNER) |
Authorized Official Contact | 9128802288 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 134 Midway GA 31320-0134 Ph: (912) 880-2288 | 1718 N Coastal Hwy Midway GA 31320-3415 Ph: (912) 880-2288 |
NPI Number | 1780043000 |
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Provider Enumeration Date | 02/15/2016 |
Last Update Date | 02/15/2016 |
Identifier | Type | State | Issuer |
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1780043000 | NPI | - | NPPES |