Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. JACKSON PETTY, DDS
ActiveDR. JACKSON PETTY, DDS is a General Dentistry healthcare provider located in TULLAHOMA, Tennessee. NPI 1417565193 is currently active in the NPPES registry. Verify at CMS.
General Dentistry · TULLAHOMA, TN
Registration Details
- NPI Number
- 1417565193
- Provider Type
- Individual
- Gender
- Unknown
- NPI Issued
- Jul 17, 2020 (6.0897775502031 yrs)
- Last Updated
- Jan 21, 2025
- Licenses
-
204657 (CO)11423 (TN)
Practice Information
- Address
-
2118 N JACKSON STTULLAHOMA, TN, 373882208Browse TN providers · Browse ZIP 37388
- Phone
- 9314549499
- Fax
- 9314549499
- Primary Specialty
-
General Dentistry
1223G0001X
- Additional Specialty
- General Dentistry
Other General Dentistry Providers in TULLAHOMA, TN
| Name | Credential | NPI |
|---|---|---|
| DR. JOHN E PETTY | DMD | 1558352997 |
| LARRY A WOODS | D.D.S. | 1841270683 |
| KIM R GLICK | D.D.S. | 1992785711 |
| DR. DALE OWEN HUNTER II | D.M.D. | 1912945734 |
| HAROLD MICHAEL LONG | D.D.S. | 1184635203 |
| DR. CHRISTOPHER DOUGLAS ANDERSON | DDS | 1528137742 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.