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1629183777
TANISHA A JACKSON
IRVINE, CA
NPI
1629183777
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: CA 47103)
Enumeration Date
2006-08-20
Last Update Date
2007-07-08
Business Address
Dr. TANISHA A JACKSON DDS
2860 MICHELLE 2ND FLOOR
IRVINE, CA 92606-1009
Phone number: 714-508-3600
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Mailing Address
Dr. TANISHA A JACKSON DDS
422 ORANGE ST
REDLANDS, CA 92374-3206
Phone number: 909-792-7500
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