Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
KEVIN R JACKSON, DDS
Active Sole ProprietorKEVIN R JACKSON, DDS is a Pediatric Dentistry healthcare provider located in POWDER SPRINGS, Georgia. NPI 1265570683 is currently active in the NPPES registry. Verify at CMS.
Pediatric Dentistry · POWDER SPRINGS, GA
Registration Details
- NPI Number
- 1265570683
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Feb 1, 2007 (19.573434981168 yrs)
- Last Updated
- Jul 10, 2007
- License
-
DN012902 (GA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
4150 MACLAND RDSUITE 205POWDER SPRINGS, GA, 301271202Browse GA providers · Browse ZIP 30127
- Phone
- 7702221344
- Fax
- 7702221345
- Primary Specialty
-
Pediatric Dentistry
1223P0221X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.