Jackson, Kevin R

Jackson, Kevin R is an sole proprietor health care provider with primary practice located at 4150 Macland Rd Suite 205, Powder Springs GA 30127-1202. He recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as his primary health care specialty. Jackson, Kevin R can be contacted via phone (770) 222-1344.

Contact Information

Primary practice address
4150 Macland Rd Suite 205 Powder Springs GA 30127-1202
Phone: (770) 222-1344
Fax: (770) 222-1345
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Pediatric Dentistry 1223P0221X DN012902 Georgia

Profile Details

NPI number 1265570683
LBN Legal business name Jackson, Kevin R
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 1st, 2007
Last updated Jul 10th, 2007 - about 17 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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