| Jackson Dental Clinic | |
|
345 North Mart Plaza Jackson MS 39206 | |
| (601) 981-1000 | |
| (601) 981-9440 |
| Full Name | Jackson Dental Clinic |
|---|---|
| Speciality | Dentist |
| Location | 345 North Mart Plaza, Jackson, Mississippi |
| Authorized Official Name and Position | Kenneth Anthony Bailey (OWNER/DENTIST) |
| Authorized Official Contact | 6019811000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jackson Dental Clinic 345 North Mart Plaza Jackson MS 39206 Ph: (601) 981-1000 | Jackson Dental Clinic 345 North Mart Plaza Jackson MS 39206 Ph: (601) 981-1000 |
| NPI Number | 1346015385 |
|---|---|
| Provider Enumeration Date | 11/20/2023 |
| Last Update Date | 11/20/2023 |
| Certification Date | 11/20/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346015385 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (NU) | Primary |
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