Individual
DR. ROBERT W JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
209 MIMOSA DR, THOMASVILLE, GA 31792-6633
(229) 226-1919
(229) 226-7709
Mailing address
PO BOX 1696, THOMASVILLE, GA 31799-1696
(229) 226-1919
(229) 226-7709
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DN007586
GA
Other
Enumeration date
12/06/2006
Last updated
07/08/2007
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