Organization
MT. JULIET DENTAL GROUP, PC
Active
Other names
Mt. Juliet Dental Group
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TANISHA A JACKSON DDS (OWNER DENTIST)
(615) 241-8023
Entity
Organization
Contact information
Practice address
4155 N MT JULIET RD, MT. JULIET, TN 37122
(615) 241-8023
(615) 922-3768
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
09/23/2016
Last updated
10/21/2016
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