Organization
ELITE DENTAL CARE JACKSON
Active
Other names
Elite Dental Care Jackson
Organization subpart
No
Provider details
NPI number
Authorized official
TOM LANNOM (CHIEF OPERATING OFFICER)
(731) 855-1053
Entity
Organization
Contact information
Practice address
47 N STAR DR, JACKSON, TN 38305-6647
(731) 664-9556
Mailing address
2066 US HIGHWAY 45 BYP S, TRENTON, TN 38382-3507
(731) 855-1053
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
07/18/2022
Last updated
07/18/2022
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