Organization
TONJOLIQUE J. JACKSON DDS, PC
Active
Other names
Shine Dental Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TONJOLIQUE JAMES JACKSON DDS (OWNER)
(972) 293-8033
Entity
Organization
Contact information
Practice address
950 E BELT LINE RD, SUITE 130, CEDAR HILL, TX 75104-2422
(972) 293-8033
(972) 293-8028
Mailing address
950 E BELT LINE RD, SUITE 130, CEDAR HILL, TX 75104-2422
(972) 293-8033
(972) 293-8028
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
23084
TX
Other
Enumeration date
08/14/2012
Last updated
08/14/2012
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