Individual
DR. TANNER JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1222 N FRONTAGE RD, HASTINGS, MN 55033-2359
(651) 437-1166
Mailing address
219 WOODRIDGE DR, CANNON FALLS, MN 55009-1226
(507) 298-0833
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D14552
MN
Other
Enumeration date
06/02/2021
Last updated
06/02/2021
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