Individual
JEFFREY JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S
Contact information
Practice address
1395 CENTER DR, GAINESVILLE, FL 32610-3006
(352) 273-7643
Mailing address
1395 CENTER DR, GAINESVILLE, FL 32610-3006
(352) 273-7643
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
8666
SC
Other
Enumeration date
02/01/2016
Last updated
02/01/2016
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