Individual
DR. GEOFFREY ALAN JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
19048 BRUCE B DOWNS BLVD, TAMPA, FL 33647-2434
(813) 972-1201
Mailing address
19048 BRUCE B DOWNS BLVD, TAMPA, FL 33647-2434
(813) 972-1201
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
14511
MD
122300000X
Dentist
Primary
DN 18870
FL
Other
Enumeration date
12/31/2009
Last updated
12/31/2009
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