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2340 Lebanon Pike Nashville TN 37214 | |
| (615) 830-5008 | |
| (615) 830-5383 |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 2340 Lebanon Pike, Nashville, Tennessee |
| Authorized Official Name and Position | Tanisha A Jackson (OWNER DOCTOR) |
| Authorized Official Contact | 6158305008 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
17000 Red Hill Ave Irvine CA 92614-5626 Ph: (714) 845-8890 | 2340 Lebanon Pike Nashville TN 37214 Ph: (615) 830-5008 |
| NPI Number | 1912387242 |
|---|---|
| Provider Enumeration Date | 06/02/2015 |
| Last Update Date | 06/02/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912387242 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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