Organization
GEORGE M SHORT DDS MS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GEORGE MICHAEL SHORT DDS MS (PRESIDENT)
(731) 668-3411
Entity
Organization
Contact information
Practice address
33 STONEBRIDGE BLVD, JACKSON, TN 38305-2042
(731) 668-3411
(731) 668-3410
Mailing address
33 STONEBRIDGE BLVD, JACKSON, TN 38305-2042
(731) 668-3411
(731) 668-3410
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
DS2421
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3219278
—
TN
Enumeration date
09/11/2006
Last updated
08/22/2020
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