Individual
DR. DOLPHUS CARL JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S., P.C.
Contact information
Practice address
4012 OHALLORN DR STE A, SPRING HILL, TN 37174-2214
(615) 302-8471
(615) 302-8081
Mailing address
4012 OHALLORN DR STE A, SPRING HILL, TN 37174-2214
(615) 302-8471
(615) 302-8081
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DS0000008035
TN
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
DS08035
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0015802
ASSURANT EMPLOYEE BNFTS
TN
01
—
281433
CIGNA DMO DENTAL PLAN
TN
05
—
3731118
—
TN
01
—
4105175
TENNCARE SELECT
TN
01
—
9176594
DORAL USA
TN
Enumeration date
12/06/2006
Last updated
03/12/2025
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