Organization
JOSEPH C. JACKSON, JR., DDS, PA
Active
Other names
Jackson Orthodontics
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSEPH C. JACKSON JR. DDS (ORTHODONTIST)
(727) 397-0353
Entity
Organization
Contact information
Practice address
8250 BRYAN DAIRY RD, #325, LARGO, FL 33777-1353
(727) 397-0353
(727) 397-5773
Mailing address
8250 BRYAN DAIRY RD, #325, LARGO, FL 33777-1353
(727) 397-0353
(727) 397-5773
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DN5413
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
85760
BCBS
FL
01
—
DN5413
STATE LICENSE
FL
Enumeration date
05/02/2007
Last updated
08/22/2020
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