Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. JACK ALLEN DAVIDSON JR., DDS, MD
ActiveDR. JACK ALLEN DAVIDSON JR., DDS, MD is a Oral & Maxillofacial Surgery healthcare provider located in LITHIA, Florida. NPI 1831289099 is currently active in the NPPES registry. Verify at CMS.
Oral & Maxillofacial Surgery · LITHIA, FL
Registration Details
- NPI Number
- 1831289099
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Oct 16, 2006 (19.78503854667 yrs)
- Last Updated
- Jul 9, 2025
- Licenses
-
ME72794 (FL)10794 (MD)
Practice Information
- Address
-
16141 FISHHAWK BLVD STE BLITHIA, FL, 335474380Browse FL providers · Browse ZIP 33547
- Phone
- 8135711516
- Fax
- 8135711626
- Primary Specialty
-
Oral & Maxillofacial Surgery
1223S0112X
- Additional Specialty
- Oral & Maxillofacial Surgery
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.