| George M Short DDS MS PC | |
|
33 Stonebridge Blvd Jackson TN 38305-2042 | |
| (731) 668-3411 | |
| (731) 668-3410 |
| Full Name | George M Short DDS MS PC |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 33 Stonebridge Blvd, Jackson, Tennessee |
| Authorized Official Name and Position | George Michael Short (PRESIDENT) |
| Authorized Official Contact | 7316683411 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| George M Short DDS MS PC 33 Stonebridge Blvd Jackson TN 38305-2042 Ph: (731) 668-3411 | George M Short DDS MS PC 33 Stonebridge Blvd Jackson TN 38305-2042 Ph: (731) 668-3411 |
| NPI Number | 1982708020 |
|---|---|
| Provider Enumeration Date | 09/11/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982708020 | NPI | - | NPPES |
| 3219278 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | DS2421 (Tennessee) | Primary |
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