Organization
R. COREY JACKSON DDS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RONALD COREY JACKSON D.D.S. (MANAGING MEMBER)
(615) 754-5840
Entity
Organization
Contact information
Practice address
2365 N MOUNT JULIET RD, MT JULIET, TN 37122-3038
(615) 754-5840
Mailing address
308 GRANDVIEW DR, OLD HICKORY, TN 37138-1645
(615) 758-9670
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8279
TN
Other
Enumeration date
10/04/2006
Last updated
08/22/2020
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