Dainty J Jackson, D. O.

NPI #1194765834 in Waldorf, Maryland

Provider Information

NPI Number: 1194765834
Entity Type: Individual
Name: Dainty J Jackson, D. O.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Family Medicine
Credential: D. O.
Enumeration Date: Jun 8, 2006
Last Updated: Feb 8, 2019

Practice Location

Address: 11315 PEMBROOKE SQ STE 112
City: Waldorf
State: Maryland
ZIP Code: 20603-4806
Phone: (301) 885-3350

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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