Provider Demographics
NPI:1659405413
Name:MCCALL, JAMES JEFFERS (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:JEFFERS
Last Name:MCCALL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5101 GATE PKWY STE 5
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-7276
Mailing Address - Country:US
Mailing Address - Phone:904-620-9225
Mailing Address - Fax:904-620-9983
Practice Address - Street 1:5101 GATE PKWY STE 5
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-7276
Practice Address - Country:US
Practice Address - Phone:904-620-9225
Practice Address - Fax:904-620-9983
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN012749122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist