Individual
DR. KEITH DANIEL JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
244 HYDRAULIC RIDGE RD, CHARLOTTESVILLE, VA 22901-8124
(434) 973-3348
(434) 977-5790
Mailing address
244 HYDRAULIC RIDGE RD, CHARLOTTESVILLE, VA 22901-8124
(434) 973-3348
(434) 977-5790
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
0401415969
VA
Other
Enumeration date
07/23/2013
Last updated
03/26/2024
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