| Aspen Dental | |
|
1119 Vann Dr Jackson TN 38305-6098 | |
| (731) 660-8981 | |
| (731) 660-7398 |
| Full Name | Aspen Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1119 Vann Dr, Jackson, Tennessee |
| Authorized Official Name and Position | Elliott Hodges Dudley (OWNER) |
| Authorized Official Contact | 7316608981 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Aspen Dental Po Box 3189 Syracuse NY 13220-3189 Ph: (315) 454-6000 | Aspen Dental 1119 Vann Dr Jackson TN 38305-6098 Ph: (731) 660-8981 |
| NPI Number | 1043676604 |
|---|---|
| Provider Enumeration Date | 01/12/2016 |
| Last Update Date | 01/12/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043676604 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DS0000009633 (Tennessee) | Primary |
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