KEVIN R JACKSON

POWDER SPRINGS, GA
NPI1265570683
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1223P0221X Dentist, Pediatric Dentistry
(Licence: GA  DN012902)
Enumeration Date2007-02-01
Last Update Date2007-07-10
Business Address
-- KEVIN R JACKSON DDS
4150 MACLAND RD SUITE 205
POWDER SPRINGS, GA 30127-1202
Phone number: 770-222-1344
Mailing Address
-- KEVIN R JACKSON DDS
5605 MAXON MARSH DR
HIRAM, GA 30141-2880
Phone number: