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Organization

ELBERT E JACKSON, DDS, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ELBERT E JACKSON DDS (OWNER)
(615) 859-1881
Entity
Organization

Contact information

Practice address
200 GLEAVES ST, SUITE C, MADISON, TN 37115-2154
(615) 859-1881
(615) 865-7723
Mailing address
200 GLEAVES ST, SUITE C, MADISON, TN 37115-2154
(615) 859-1881
(615) 865-7723

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DS2474
TN

Other

Enumeration date
12/06/2006
Last updated
08/22/2020
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