| John M. Jackson, Jr., D.M.D., P.C. | |
|
304 S Lewis St Lagrange GA 30240-3144 | |
| (706) 845-0544 | |
| Not Available |
| Full Name | John M. Jackson, Jr., D.M.D., P.C. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 304 S Lewis St, Lagrange, Georgia |
| Authorized Official Name and Position | John Morgan Jackson (PRESIDENT) |
| Authorized Official Contact | 7068450544 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| John M. Jackson, Jr., D.M.D., P.C. 304 S Lewis St Lagrange GA 30240-3144 Ph: (706) 845-0544 | John M. Jackson, Jr., D.M.D., P.C. 304 S Lewis St Lagrange GA 30240-3144 Ph: (706) 845-0544 |
| NPI Number | 1033455647 |
|---|---|
| Provider Enumeration Date | 12/31/2012 |
| Last Update Date | 12/31/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033455647 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DN010331 (Georgia) | Primary |
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