Individual
DR. JACKSON TUCKER GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
875 UNION AVE, MEMPHIS, TN 38163-2211
(901) 448-1731
Mailing address
7794 KINGS COLLEGE AVE APT 382, GERMANTOWN, TN 38138-2098
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
D011416
AZ
390200000X
Student in an Organized Health Care Education/Training Program
Primary
D011416
AZ
Other
Enumeration date
06/09/2022
Last updated
05/12/2025
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