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Individual
SCOTT A. JACKSON
Active
Individual
SCOTT A. JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN 0014031
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
59175333
BC/BS OF ALABAMA
FL
01
—
867365
UNITED CONCORDIA
FL
01
—
JA1B0355
BC/BS OF MASS
FL
Enumeration date
07/03/2006
Last updated
07/08/2007
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