Organization
JACKSON SMILE STUDIO - SDA LLC
Active
Other names
Jackson Smile Studio
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JENNI TOMLINSON (CREDENTIALING SPECIALIST)
(803) 678-9999
Entity
Organization
Contact information
Practice address
3790 FERNANDINA RD STE 201, COLUMBIA, SC 29210-3864
(803) 678-9999
(803) 750-0021
Mailing address
225 TOWNPARK DR NW STE 100, KENNESAW, GA 30144-5885
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
11/06/2018
Last updated
10/09/2023
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