Organization
SMYRNA MODERN DENTISTRY, PC
Active
Other names
Smyrna Modern Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TANISHA A JACKSON DDS (OWNER)
(615) 930-9606
Entity
Organization
Contact information
Practice address
160 MOVIE ROW, SMYRNA, TN 37167
(615) 930-9606
(615) 459-0003
Mailing address
17000 RED HILL AVE, IRVINE, CA 92614-5626
(714) 845-8890
(949) 474-1495
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
09/11/2015
Last updated
09/11/2015
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