Individual
DR. DANNY KEITH TACKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2707 JACKSBORO PIKE, SUITE #4, JACKSBORO, TN 37757-2752
(423) 566-0401
(423) 566-0423
Mailing address
2707 JACKSBORO PIKE, SUITE #4, JACKSBORO, TN 37757-2752
(423) 566-0401
(423) 566-0423
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS7240
TN
Other
Enumeration date
08/18/2005
Last updated
09/18/2007
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