Organization
JACKSON FAMILY DENTISTRY PC
Active
Other names
Dr Andrew Lee Jackson DMD Dr Celestine Vernedoe DMD
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANDREW LEE JACKSON DMD (OWNER PRESIDENT)
(912) 283-1340
Entity
Organization
Contact information
Practice address
2009 TEBEAU STREET, WAYCROSS, GA 31501
(912) 283-1340
(912) 283-0334
Mailing address
2009 TEBEAU STREET, WAYCROSS, GA 31501
(912) 283-1340
(912) 283-0334
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
9840
GA
1223G0001X
General Practice Dentistry
Primary
9939
GA
Other
Enumeration date
03/06/2007
Last updated
02/12/2008
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