Organization
JACK C SHANNON DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACK CANADA SHANNON DDS (PRESIDENT)
(901) 756-0027
Entity
Organization
Contact information
Practice address
8065 CLUB PARKWAY, SUITE 2, CORDOVA, TN 38016-5967
(901) 756-0027
(901) 756-9715
Mailing address
8065 CLUB PARKWAY, SUITE 2, CORDOVA, TN 38016-5967
(901) 756-0027
(901) 756-9715
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS2485
TN
Other
Enumeration date
12/12/2006
Last updated
08/22/2020
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