Individual
ROLLIN B JACKSON III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1718 N COASTAL HWY, MIDWAY, GA 31320-3415
(912) 880-2288
(912) 880-2110
Mailing address
PO BOX 134, MIDWAY, GA 31320-0134
(912) 880-2288
(912) 880-2110
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN013091
GA
Other
Enumeration date
02/13/2007
Last updated
11/09/2016
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