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Organization
JACKSON AND MOORE PROFESSIONAL CORPORATION
Active
Organization
JACKSON AND MOORE PROFESSIONAL CORPORATION
Active
Other names
HUB PLAZA DENTAL GROUP
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TANISHA A JACKSON DDS (OWNER DDS)
(909) 796-6700
Entity
Organization
Contact information
Practice address
1047 HARRIMAN PL, STE. B, SAN BERNARDINO, CA 92408-4203
(909) 796-6700
(909) 796-6779
Mailing address
2860 MICHELLE, 2ND FLOOR, IRVINE, CA 92606-1009
(714) 508-3600
(714) 368-2092
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
09/16/2006
Last updated
05/29/2009
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