| Jackson Dental Alliance, Pllc | |
|
40 W Caldwell St Ste 202 Mt Juliet TN 37122-3179 | |
| (615) 758-7511 | |
| Not Available |
| Full Name | Jackson Dental Alliance, Pllc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 40 W Caldwell St Ste 202, Mt Juliet, Tennessee |
| Authorized Official Name and Position | Ronald Corey Jackson (PRESIDENT/CEO) |
| Authorized Official Contact | 6154066780 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jackson Dental Alliance, Pllc 2740 S Mount Juliet Rd Mount Juliet TN 37122-6202 Ph: (615) 406-6780 | Jackson Dental Alliance, Pllc 40 W Caldwell St Ste 202 Mt Juliet TN 37122-3179 Ph: (615) 758-7511 |
| NPI Number | 1396431060 |
|---|---|
| Provider Enumeration Date | 04/14/2023 |
| Last Update Date | 04/14/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396431060 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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