JACK A DAVIDSON DDS MD PLLC NPI 1548403314

NPI Information

JACK A DAVIDSON DDS MD PLLC is a plastic and reconstructive surgery surgery in Brandon, FL. The provider is a surgeon who specializes in plastic and reconstructive surgery. JACK A DAVIDSON DDS MD PLLC NPI is 1548403314. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1165 NIKKI VIEW DR
BRANDON, FL
ZIP 33511-879
Phone: (813) 571-1516
Fax: (813) 571-1626

The provider's authorized official is Jack Allen Davidson .
The authorized official title is Owner and has the following contact phone number (813) 571-1516.

The enumeration date for this NPI number is 4/9/2009 and was last updated on 4/9/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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