Organization
JACKSON DENTAL ALLIANCE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RONALD COREY JACKSON DDS (PRESIDENT/CEO)
(615) 406-6780
Entity
Organization
Contact information
Practice address
40 W CALDWELL ST STE 202, MT JULIET, TN 37122-3179
(615) 758-7511
Mailing address
2740 S MOUNT JULIET RD, MOUNT JULIET, TN 37122-6202
(615) 406-6780
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
04/14/2023
Last updated
04/14/2023
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