Davidson, Jack Allen

Davidson, Jack Allen is an individual health care provider with primary practice located at 1165 Nikki View Dr , Brandon FL 33511-4879. He recently has 2 registered licenses in different health care specialties including Dental Providers / Oral and Maxillofacial Surgery, Allopathic & Osteopathic Physicians / Plastic Surgery. Allopathic & Osteopathic Physicians / Plastic Surgery is his primary health care specialty. Davidson, Jack Allen can be contacted via phone (813) 571-1516.

Contact Information

Primary practice address
1165 Nikki View Dr Brandon FL 33511-4879
Phone: (813) 571-1516
Fax: (813) 571-1626
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 10794 Maryland
Allopathic & Osteopathic Physicians / Plastic Surgery 208200000X ME72794 Florida

Profile Details

NPI number 1831289099
LBN Legal business name Davidson, Jack Allen
Credentials DDS, MD
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 16th, 2006
Last updated Apr 14th, 2009 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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