| NPI | 1548738636 | 
|---|---|
| Doing Business As | JACKSON SMILE STUDIO | 
| Entity Type | Organization | 
| Authorized Contact | JENNI TOMLINSON Credentialing Specialist 803-678-9999  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 1223G0001X Dentist, General Practice | 
| Enumeration Date | 2018-11-06 | 
| Last Update Date | 2023-10-09 |