Individual provider · Type 1 NPI
Jack Allen Davidson Jr., DDS, MD
Oral and Maxillofacial Surgery (Dentist) · Lithia, FL
NPI number
1831289099
Active
Practice location
16141 Fishhawk Blvd Ste B
Lithia, FL 33547-4380
Fax (813) 571-1626
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Plastic Surgery Physician | 208200000X | ME72794 (FL) |
| Oral and Maxillofacial Surgery (Dentist) Primary | 1223S0112X | 10794 (MD) |
Oral and Maxillofacial Surgery (Dentist): The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
Another provider at this address
About NPI 1831289099
Jack Allen Davidson Jr., DDS, MD's National Provider Identifier is 1831289099, issued on Oct 16, 2006. The primary taxonomy on file is Oral and Maxillofacial Surgery (Dentist) (1223S0112X), and the practice location is in Lithia, FL. The record was last updated on Jul 9, 2025.