Individual
DR. GEORGE M SHORT
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.D.S., M.S.
Contact information
Practice address
33 STONEBRIDGE BLVD, JACKSON, TN 38305-2042
(731) 668-3411
(731) 668-3410
Mailing address
33 STONEBRIDGE BLVD, JACKSON, TN 38305-2042
(731) 668-3411
(731) 668-3410
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
DS2421
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3219278
—
TN
Enumeration date
10/18/2005
Last updated
07/09/2007
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