Individual
DR. JEROME ADRIAN JACKSON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
18849 KINGS HWY, MONTROSS, VA 22520-2965
(804) 493-9999
Mailing address
18849 KINGS HWY, MONTROSS, VA 22520-2965
(804) 493-9999
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401416132
VA
1223G0001X
General Practice Dentistry
DEN4663
ME
Other
Enumeration date
09/21/2018
Last updated
06/01/2021
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