| Elbert E Jackson, Dds, Pc | |
|
200 Gleaves St Suite C Madison TN 37115-2154 | |
| (615) 859-1881 | |
| (615) 865-7723 |
| Full Name | Elbert E Jackson, Dds, Pc |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 200 Gleaves St, Madison, Tennessee |
| Authorized Official Name and Position | Elbert E Jackson (OWNER) |
| Authorized Official Contact | 6158591881 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Elbert E Jackson, Dds, Pc 200 Gleaves St Suite C Madison TN 37115-2154 Ph: (615) 859-1881 | Elbert E Jackson, Dds, Pc 200 Gleaves St Suite C Madison TN 37115-2154 Ph: (615) 859-1881 |
| NPI Number | 1871652172 |
|---|---|
| Provider Enumeration Date | 12/06/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871652172 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | DS2474 (Tennessee) | Primary |
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