Kevin Jackson, DDS

NPI 1265570683 · on the registry since 2007 · sole proprietor

Practice

Address: 4150 Macland Rd
Suite 205
Powder Springs, GA 30127
Phone: (770) 222-1344
Fax: (770) 222-1345
Organisation at this address: The Kroger Co
Young Smiles Dentistry For Kids
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 9

Registry record

Primary taxonomy: 1223P0221X
1223P0221X
Licence states on file: GA
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2007-07-10

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Georgia