Individual
DR. SAMUEL JOSEPH JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2719 LIMESTONE PKWY, GAINESVILLE, GA 30501-1472
(770) 532-7400
Mailing address
1517 WALKER ST, GAINESVILLE, GA 30501-1745
(678) 897-3768
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN123447
GA
Other
Enumeration date
06/26/2024
Last updated
06/26/2024
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