Individual
DR. TAWANN PATRICE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
650 PENNSYLVANIA AVE SE, SUITE 460, WASHINGTON, DC 20003-4318
(202) 547-7772
(202) 547-7796
Mailing address
650 PENNSYLVANIA AVE SE, SUITE 460, WASHINGTON, DC 20003-4318
(202) 547-7772
(202) 547-7796
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5105
DC
Other
Enumeration date
05/06/2007
Last updated
07/08/2007
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