Individual
MR. TERRY L JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
121 WEST MAIN STREET, WATERTOWN, TN 37184
(615) 237-3631
(615) 237-9906
Mailing address
121 WEST MAIN STREET, WATERTOWN, TN 37184
(615) 237-3631
(615) 237-9906
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4316
TN
Other
Enumeration date
11/14/2006
Last updated
07/08/2007
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