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Organization

YOUNG SMILES DENTISTRY FOR KIDS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. KEVIN R JACKSON DDS (DENTIST)
(770) 222-1344
Entity
Organization

Contact information

Practice address
4150 MACLAND RD, SUITE 205, POWDER SPRINGS, GA 30127-1202
(770) 222-1344
Mailing address
4150 MACLAND RD, SUITE 205, POWDER SPRINGS, GA 30127-1202
(770) 222-1344

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary

Other

Enumeration date
09/29/2010
Last updated
09/29/2010
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